SII NanoTechnology USA Inc.

Customer Satisfaction Survey 2008

The purpose of this survey is to ensure that SII NanoTechnology USA continually delivers products and services of the highest quality.

Instructions: There are only 10 questions that will take just a few minutes to complete. We kindly ask you to fill out this questionnaire as correctly and detailed as possible. The answers marked with an asterisk (*) are required. The name and organization of the respondents will be kept strictly confidential.

Win an iPOD Shuffle 1GB!

This year, one respondent will be drawn to win an Apple iPOD Shuffle MP3 Player with 1GB memory, USB2.0, with a weight of only 0.78 ounces!

*Required Item

*What factor(s) led to your decision to purchase your Vortex system?

*Which Vortex model do you have installed?

*Has the Vortex met your expectations for its original intended use in your research?

	Exceeded expectations
	Met expectations
	Did not meet expectations

If it did not meet expectations, please explain briefly why.

*Have you discovered additional applications for your Vortex? Please briefly explain.

*Describe your overall level of satisfaction regarding the performance of Vortex.

	Exceeded expectations
	Met expectations
	Did not meet expectations

If it did not meet expectations, please explain briefly why.

*Describe your overall level of satisfaction regarding SII NanoTechnology USA's customer service support.

	Exceeded expectations
	Met expectations
	Did not meet expectations

If it did not meet expectations, please explain briefly why

*What enhancement(s)/upgrade(s) can you envision which would improve the Vortex?

*Would you be willing to serve as a reference for SII NanoTechnology USA to prospective customers regarding Vortex?

	Yes
	No

*Are you aware of any others in your field whom SII NanoTechnolgy USA should contact to introduce them to the Vortex? If yes, please provide contact information.

*Is there any other feedback you would like to provide at this time?

Please provide your contact information.

If you wish to be anonymous, you can leave following fields empty. However, your entry will not be eligible for the raffle.

Company Name

Please enter the full name of your company
(i.e. ABC Corporation Inc.)

Department

Your Name

First

Last

Region / Country

Address

Telephone Number

i.e. 212-555-5555

Extension

Fax Number

i.e. 212-555-5555

Email Address

abc@company.com