Annual Wholesale Trade Survey - Long Questionnaire - 2016

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Table of Contents

Introduction

Purpose

This survey collects the financial and operating data needed to develop national and regional economic policies and programs.

Additional information

This survey is conducted by Statistics Canada in order to collect the necessary information to support the Integrated Business Statistics Program (IBSP). This program combines various survey and administrative data to develop comprehensive measures of the Canadian economy.

The statistical information from the IBSP serves many purposes, including:
- Calculating each province and territory's fair share of federal-provincial transfer payments for health, education and social programs;
- Establishing government programs to assist businesses;
- Assisting the business community in negotiating contracts and collective agreements;
- Supporting the government in making informed decisions about fiscal, monetary and foreign exchange policies;
- Indexing social benefit programs and determining tax brackets;
- Enabling academics and economists to analyze the economic performance of Canadian industries and to better understand rapidly evolving business environments.

Your information may also be used by Statistics Canada for other statistical and research purposes.

Your participation in this survey is required under the authority of the Statistics Act.

Authority

Data are collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19.

Confidentiality

By law, Statistics Canada is prohibited from releasing any information it collects that could identify any person, business, or organization, unless consent has been given by the respondent, or as permitted by the Statistics Act. Statistics Canada will use the information from this survey for statistical purposes only.

Data-sharing agreements

To reduce respondent burden, Statistics Canada has entered into data-sharing agreements with provincial and territorial statistical agencies and other government organizations, which have agreed to keep the data confidential and use them only for statistical purposes. Statistics Canada will only share data from this survey with those organizations that have demonstrated a requirement to use the data.

Section 11 of the Statistics Act provides for the sharing of information with provincial and territorial statistical agencies that meet certain conditions. These agencies must have the legislative authority to collect the same information, on a mandatory basis, and the legislation must provide substantially the same provisions for confidentiality and penalties for disclosure of confidential information as the Statistics Act. Because these agencies have the legal authority to compel businesses to provide the same information, consent is not requested and businesses may not object to the sharing of the data.

For this survey, there are Section 11 agreements with the provincial and territorial statistical agencies of Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia and the Yukon. The shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.

Section 12 of the Statistics Act provides for the sharing of information with federal, provincial or territorial government organizations. Under Section 12, you may refuse to share your information with any of these organizations by writing a letter of objection to the Chief Statistician, specifying the organizations with which you do not want Statistics Canada to share your data and mailing it to the following address:

Chief Statistician of Canada
Statistics Canada
Attention of Director, Enterprise Statistics Division
150 Tunney's Pasture Driveway
Ottawa, Ontario
K1A 0T6

You may also contact us by email at statcan.esd-helpdesk-dse-bureaudedepannage.statcan@canada.ca or by fax at 613-951-6583.

For this survey, there are Section 12 agreements with the statistical agencies of Prince Edward Island, the Northwest Territories and Nunavut.

For agreements with provincial and territorial government organizations, the shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.

Record linkage

To enhance the data from this survey and to reduce respondent burden, Statistics Canada may combine it with information from other surveys or from administrative sources.

Business or organization and contact information

Business or organization and contact information - Question identifier:1

Please verify or provide the business or organization's legal and operating name and correct where needed. Note: Legal name modifications should only be done to correct a spelling error or typo.

Legal name

Operating name (if applicable)

Business or organization and contact information - Question identifier:2

Please verify or provide the contact information of the designated business or organization contact person for this questionnaire and correct where needed. Note: The designated contact person is the person who should receive this questionnaire. The designated contact person may not always be the one who actually completes the questionnaire.

First name

Last name

Title

Preferred language of communication

Mailing address (number and street)

City

Province, territory or state

Postal code or ZIP code Example: A9A 9A9 or 12345-1234

Country

Email address Example: user@example.gov.ca

Telephone number (including area code) Example: 123-123-1234

Extension number (if applicable)

Fax number (including area code) Example: 123-123-1234

Business or organization and contact information - Question identifier:3

Please verify or provide the current operational status of the business or organization identified by the legal and operating name above.

.

  • 1: Operational
  • 2: Not currently operational e.g., temporarily or permanently closed, change of ownership

Why is this business or organization not currently operational?

  • 1: Seasonal operations
  • 2: Ceased operations
  • 3: Sold operations
  • 4: Amalgamated with (an) other business(es) or organization(s)
  • 5: Temporarily inactive but will re-open
  • 6: No longer operating due to other reason(s)

Business or organization and contact information - Question identifier:3a

Seasonal operations

When did this business or organization close for the season?

When does this business or organization expect to resume operations?
Date:
Example: YYYY-MM-DD

Business or organization and contact information - Question identifier:3b

Ceased operations

When did this business or organization cease operations?
Date:
Example: YYYY-MM-DD

Why did this business or organization cease operations?

  • 1: Bankruptcy
  • 2: Liquidation
  • 3: Dissolution
  • 4: Other reasons - specify:

Why did this business or organization cease operations? Other reasons - specify

Business or organization and contact information - Question identifier:3c

Sold operations

When was this business or organization sold?
Date:
Example: YYYY-MM-DD

What is the legal name of the buyer?

Business or organization and contact information - Question identifier:3d

Amalgamated with (an) other business(es) or organization(s)

When did this business or organization amalgamate?

What is the legal name of the resulting or continuing business or organization?

What is (are) the legal name(s) of the other amalgamated business(es) or organization(s)?

Business or organization and contact information - Question identifier:3e

Temporarily inactive but will re-open

When did this business or organization become temporarily inactive?

When does this business or organization expect to resume operations?

Why is this business or organization temporarily inactive?

Business or organization and contact information - Question identifier:3f

No longer operating due to other reason(s)

When did this business or organization cease operations?
Date:
Example: YYYY-MM-DD

Why did this business or organization cease operations?

Main activity

Main activity - Question identifier:4

Please verify or provide the current main activity of the business or organization identified by the legal and operating name above. Note: The described activity was assigned using the North American Industry Classification System (NAICS).

.

  • 1: This is the current main activity.
  • 2: This is not the current main activity.

This is not the current main activity - Please provide a brief but precise description of this business or organization's main activity. e.g., breakfast cereal manufacturing, shoe store, software development

Main activity - Question identifier:5

You indicated that is not the current main activity. Was this business or organization's main activity ever classified as: ?

  • 1: Yes
  • 2: No

Main activity - Question identifier:5a

When did the main activity change?

Main activity - Question identifier:6

Please search and select the industry classification code that best corresponds to this business or organization's main activity. How to search:
- if desired, you can filter the search results by first selecting this business or organization's activity sector
- enter keywords or a brief description that best describes this business or organization main activity
- press the Search button to search the database for an activity that best matches the keywords or description you provided
- then select an activity from the list.

Select this business or organization's activity sector (optional)

Enter keywords or a brief description, then press the Search button

Please select an activity (industry code)

Please select an activity (industry description)

Main activity - Question identifier:7

You have indicated that the current main activity of this business or organization is: Are there any other activities that contribute significantly (at least 10%) to this business or organization's revenue?

.

  • 1: Yes, there are other activities.
  • 2: No, that is the only significant activity.

Main activity - Question identifier:7a

Yes, there are other activities.

Please provide a brief but precise description of this business or organization's secondary activity. e.g., breakfast cereal manufacturing, shoe store, software development

Main activity - Question identifier:8

Approximately what percentage of this business or organization's revenue is generated by each of the following activities? When precise figures are not available, please provide your best estimates.

Main activity - Question identifier:a

#{__NAICS_TITLE_E}

Main activity - Question identifier:b

#{__secondary_NAICS_TITLE_E}

Main activity - Question identifier:c

All other activities.

Total percentage

Reporting period information

Reporting period information - Question identifier:1

What are the start and end dates of this business's or organization's most recently completed fiscal year? Note: For this survey, the end date should fall between Start YYYY MM DD and End YYYY+1 MM DD.

Reporting period information - Question identifier:a)

Fiscal year start date Example: YYYY-MM-DD

Reporting period information - Question identifier:b)

Fiscal Year-End date Example: YYYY-MM-DD

Reporting period information - Question identifier:2

What is the reason the reporting period does not cover a full year? Select all that apply.

  • 1: Seasonal operations
  • 2: New business
  • 3: Change of ownership
  • 4: Temporarily inactive
  • 5: Change of fiscal year
  • 6: Ceased operations
  • 7: Other reason - specify:
  • 8: Other reason - specify: Description

Revenue

Revenue - Question identifier:1

For the reporting period of MM DD YYYY to MM DD YYYY, what was this business's revenue from each of the following sources? Notes:
- A detailed breakdown may be requested in other sections.
- These questions are asked of many different industries. Some questions may not apply to this business.
Please report all amounts in thousands of Canadian dollars.

Revenue - Question identifier:a)

Sales of goods and services Exclude: GST/HST, PST and QST

Revenue - Question identifier:b)

Rental and leasing

Revenue - Question identifier:c)

Commissions

Revenue - Question identifier:d)

Subsidies Include: grants, donations and fundraising

Revenue - Question identifier:e)

Royalties, rights, licensing and franchise fees

Revenue - Question identifier:f)

Dividends

Revenue - Question identifier:g)

Interest

Revenue - Question identifier:h)

Other revenue - specify: Include: intracompany transfers

Revenue - Question identifier:h)

Other revenue - specify (description): Include: intracompany transfers

Total revenue

E-Commerce

E-Commerce - Question identifier:2

For the reporting period of YYYY MM DD to YYYY MM DD, did this business have any e-commerce revenue?

E-commerce revenue: sale of goods and services conducted over the Internet with or without online payment.
Include: all revenue for which an order is received and commitment to purchase is made via the Internet, although payment can be made by other means, such as orders made on web pages, an extranet, mobile devices or Electronic Data Interchange (EDI).
Exclude: orders made by telephone, facsimile or e-mail.

  • 1: Yes
  • 2: No

E-Commerce - Question identifier:3

Of the <####> in total revenue reported, what was the total e-commerce revenue?

If precise figures are not available, please provide your best estimate.

E-Commerce - Question identifier:4

Did this business make sales over the Internet through any of the following methods from YYYY MM DD to YYYY MM DD?
Select all that apply.

Via a mobile app

Via your company website

Via a third-party website

Via Electronic Data Interchange (EDI)

Other methods - specify:

Other methods - specify: (description)

E-Commerce - Question identifier:5

Does this business have any full-time staff dedicated solely to activities related to e-commerce?

  • 1: Yes
  • 2: No

E-Commerce - Question identifier:6

Why did this business not make sales over the Internet?
Select all that apply.

Goods and services do not lend themselves to online sales

Prefer to maintain current business model

Lack of skilled workers to implement and maintain e-commerce infrastructure

Cost of development is too high

Security concerns

Other reasons - specify:

Other reasons - specify: (description)

Expenses

Expenses - Question identifier:1

For the reporting period of MM DD YYYY to MM DD YYYY, what were this business's expenses for the following items? Notes:
- A detailed breakdown may be requested in other sections.
- These questions are asked of many different industries. Some questions may not apply to this business.
Please report all amounts in thousands of Canadian dollars.

Expenses - Question identifier:a)i.

Cost of goods sold: Opening inventories

Expenses - Question identifier:a)ii.

Cost of goods sold: Purchases -Include: raw materials, goods purchased for resale and non-returnable containers -Exclude: change in inventories

Expenses - Question identifier:a)iii.

Cost of goods sold: Closing inventories

Expenses - Question identifier:a)iv.

Cost of goods sold: Cost of goods sold Opening inventories plus purchases minus closing inventories

Expenses - Question identifier:b)i.

Employment costs and expenses -Include: all employees who were issued a T4 -Exclude: commissions paid to non-employees (report at question c.): Salaries, wages and commissions

Expenses - Question identifier:b)ii.

Employment costs and expenses -Include: all employees who were issued a T4 -Exclude: commissions paid to non-employees (report at question c.): Employee benefits -Refer to the ?Help button for the list of inclusions and exclusions

Expenses - Question identifier:c)

Subcontracts Include: commissions paid to non-employees.
Exclude: research and development.

Expenses - Question identifier:d)

Research and development fees -Exclude: in-house research and development

Expenses - Question identifier:e)

Professional and business fees -e.g., legal, accounting, consulting, scientific fees

Expenses - Question identifier:f)

Utilities -e.g., electricity, water, gas

Expenses - Question identifier:g)

Office and computer related expenses -e.g., office supplies, postage, computer upgrades

Expenses - Question identifier:h)

Telephone, internet and other telecommunication

Expenses - Question identifier:i)

Business taxes, licenses and permits e.g., beverage tax, business tax, license fees, property taxes

Expenses - Question identifier:j)

Royalties, franchise fees and memberships -Exclude: Crown royalties

Expenses - Question identifier:k)

Crown charges (for logging, mining and energy industries only)

Expenses - Question identifier:l)

Rental and leasing -Include: land, building, equipment, vehicles

Expenses - Question identifier:m)

Repair and maintenance -Include: buildings, equipment, vehicles

Expenses - Question identifier:n)

Amortization and depreciation

Expenses - Question identifier:o)

Insurance

Expenses - Question identifier:p)

Advertising, marketing, promotion, meals and entertainment

Expenses - Question identifier:q)

Travel, meetings and conventions

Expenses - Question identifier:r)

Financial services e.g., bank charges, transaction fees

Expenses - Question identifier:s)

Interest expense

Expenses - Question identifier:t)

Other non-production-related costs and expenses -Include: bad debt, loan losses, donations, political contributions and inventory write-down

Expenses - Question identifier:u)

All other cost and expenses - specify: Include: intracompany expenses.

Expenses - Question identifier:u)

All other cost and expenses - specify: Include: intracompany expenses (description)

Total expenses

Industry characteristics

Industry characteristics - Question identifier:1

What were this business's sales and revenue for each of the following products and services? Please report all amounts in thousands of Canadian dollars.

Industry characteristics - Question identifier:a)

All products purchased for resale
Report sales net of returns, discounts and rebates. -Include: parts used in generating repair and maintenance revenue -Exclude: labour revenue from repair and maintenance (report at question c.).

Industry characteristics - Question identifier:b)

Products manufactured as a secondary activity by this business

Industry characteristics - Question identifier:c)

Repair and maintenance services -Exclude: sales of parts as reported at question a.

Industry characteristics - Question identifier:d)

Rental and leasing of real estate

Industry characteristics - Question identifier:e)

Rental and leasing of products and equipment -Exclude: sales of parts as reported at question a.

Industry characteristics - Question identifier:2

What was the value of products where commissions and fees were earned by this business acting as an agent or broker?

Value of products

Industry characteristics - Question identifier:3

Did this business purchase goods (raw materials, semi-finished, or finished goods) "off the shelf" outside of Canada and sell them "as-is" in foreign markets (including the U.S.) without altering the goods, and without the goods entering Canada before the sale?

.

  • 1: Yes
  • 2: No
  • 3: Don't know

Don't know -Provide comments if desired.

Industry characteristics - Question identifier:4

On YYYY MM DD, last day of the fiscal year, did this business hold inventories abroad, including inventories in transit to Canada? Include: raw materials, work in process, and finished goods recorded in this business's accounting books, but physically located outside of Canada. Also include goods purchased abroad for resale "as-is" in foreign markets.

.

  • 1: Yes
  • 2: No
  • 3: Don't know

Don't know -Provide comments if desired.

Industry characteristics - Question identifier:5

What was the approximate value of inventories held abroad at the end of the reporting period? Please report all amounts in thousands of Canadian dollars.

Industry characteristics - Question identifier:6

Is the value reported above included in the $ [###] closing inventories previously reported in question 1.a.iii from the expenses section?

  • 1: Yes
  • 2: No

Details on purchased services

Details on purchased services - Question identifier:1

For the reporting period YYYY MM DD to YYYY MM DD, this business reported expenses for the following items. Please provide the requested details related to these expenses. Please report all amounts in thousands of Canadian dollars.

Details on purchased services - Question identifier:a

Professional and business fees Legal services

Details on purchased services - Question identifier:b

Professional and business fees Accounting, tax preparation, bookkeeping and payroll services

Details on purchased services - Question identifier:c

Professional and business fees Management, scientific and technical consulting services Include: training

Details on purchased services - Question identifier:d

Professional and business fees Office administrative services

Details on purchased services - Question identifier:e

Professional and business fees Freight transportation arrangements and customs brokering services

Details on purchased services - Question identifier:f

Professional and business fees Brokerage and other insurance related services

Details on purchased services - Question identifier:g

Professional and business fees Security brokerage and securities dealing services

Details on purchased services - Question identifier:h

Professional and business fees Other purchased professional services

Professional and business fees Total expenses for professional and business fees (should be equal to or less than the total from question 1e. reported in expenses section: <####>)

Details on purchased services - Question identifier:a

Office and computer related expenses Data processing, hosting, and related services

Details on purchased services - Question identifier:b

Office and computer related expenses Business support services Include: reproductions, call centres, debt collection

Details on purchased services - Question identifier:c

Office and computer related expenses Other office and computer related purchased services

Office and computer related expenses Total expenses for office and computer related expenses (should be equal to or less than the total from question 1g. reported in the expenses section: <####>)

Details on purchased services - Question identifier:a

Royalties, franchise fees and memberships Rights to non-financial intangible assets

Details on purchased services - Question identifier:b

Royalties, franchise fees and memberships Membership fees or services

Details on purchased services - Question identifier:c

Royalties, franchise fees and memberships Other royalties, franchise fees and memberships

Royalties, franchise fees and memberships Total expenses for royalties, franchise fees and memberships (should be equal to or less than the total from question 1j. reported in expenses section: <####>)

Details on purchased services - Question identifier:a

Rental and leasing Non-residential real estate rental

Details on purchased services - Question identifier:b

Rental and leasing Motor vehicle rental and leasing

Details on purchased services - Question identifier:c

Rental and leasing Computer equipment rental and leasing

Details on purchased services - Question identifier:d

Rental and leasing Office machinery and equipment rental and leasing services Exclude: computer equipment

Details on purchased services - Question identifier:e

Rental and leasing Commercial and industrial machinery and equipment renting and leasing services, without operator Exclude: office equipment

Details on purchased services - Question identifier:f

Rental and leasing Other rental services

Rental and leasing Total expenses for rental and leasing (should be equal to or less than the total from question 1l. reported in expenses section: <####>)

Details on purchased services - Question identifier:a

Repair and maintenance Security services and investigation

Details on purchased services - Question identifier:b

Repair and maintenance Waste management and remediation services

Details on purchased services - Question identifier:c

Repair and maintenance Motor vehicle repair and maintenance services

Details on purchased services - Question identifier:d

Repair and maintenance Other repair and maintenance services

Repair and maintenance Total expenses for repair and maintenance (should be equal to or less than the total from question 1m. reported in expenses section: <####>)

Sales by type of client

Sales by type of client - Question identifier:1

What was this business's breakdown of sales by the following types of client?

Sales by type of client - Question identifier:a

Clients in Canada - individuals and households

Sales by type of client - Question identifier:b

Clients in Canada - businesses

Sales by type of client - Question identifier:c

Clients in Canada - governments, not-for-profit organizations and public institutions e.g., hospitals and schools

Clients outside of Canada

Total percentage

Province/country of origin and destination of products sold

Province/country of origin and destination of products sold - Question identifier:1

According to our records, this business sells the following products. Please review the list of products, and for each one, indicate whether it was sold during the reporting period of YYYY MM DD to YYYY MM DD

Product code

Product

Was this product sold during this reporting period?

  • 1: Yes
  • 2: No

Province/country of origin and destination of products sold - Question identifier:2

Did this business sell any other products during the reporting period of YYYY MM DD to YYYY MM DD?

.

  • 1: Yes
  • 2: No

How many other types of products were sold?

Province/country of origin and destination of products sold - Question identifier:3

For each additional product sold, please provide a brief description.

Province/country of origin and destination of products sold - Question identifier:4

For [product], what was the cost of goods sold? When precise figures are not available, please provide your best estimate.

Province/country of origin and destination of products sold - Question identifier:5

For [product], what was the percentage breakdown of the cost of goods sold by origin (province, territory or country outside Canada)? Note: The origin is the physical location where the products were originally produced/manufactured. The location of your supplier is an acceptable substitute.

Newfoundland and Labrador

Prince Edward Island

Nova Scotia

New Brunswick

Quebec

Ontario

Manitoba

Saskatchewan

Alberta

British Columbia

Yukon

Northwest Territories

Nunavut

United States

China

Other

Total percentage

Province/country of origin and destination of products sold - Question identifier:6

What were the sales of [product]? When precise figures are not available, please provide your best estimate.

Province/country of origin and destination of products sold - Question identifier:7

For [product], what was the percentage breakdown of sales by destination (i.e.,province, territory, or country outside Canada)? Note: The destination is where the products will ultimately be used.

Newfoundland and Labrador

Prince Edward Island

Nova Scotia

New Brunswick

Quebec

Ontario

Manitoba

Saskatchewan

Alberta

British Columbia

Yukon

Northwest Territories

Nunavut

United States

China

Other

Total percentage

Details on this business's locations

Details on this business's locations - Question identifier:1

Please verify the location address and correct where needed.

Operating name:

Address (number and street):

City:

Province, territory:

  • 1: Alberta
  • 2: British Columbia
  • 3: Manitoba
  • 4: New Brunswick
  • 5: Newfoundland and Labrador
  • 6: Nova Scotia
  • 7: Northwest Territories
  • 8: Nunavut
  • 9: Ontario
  • 10: Prince Edward Island
  • 11: Quebec
  • 12: Saskatchewan
  • 13: Yukon Territory

Postal code: Example: A9A 9A9

Total operating revenue:

Details on this business's locations - Question identifier:2

Was this business location operational for the full year?

  • 1: Yes, full-year operation
  • 2: No, part-year operation

Details on this business's locations - Question identifier:3

Statistics Canada reviews all feedback. We invite your comments pertaining to this business location.

Details on this business's locations - Question identifier:4

What were this location's part year start and end dates?

Part Year Operation Start Date: Example: YYYY-MM-DD

Part Year Operation End Date: Example: YYYY-MM-DD

Seasonal operation

Ceased operations

New store

Temporarily closed

Change of fiscal year

Moved

Change of ownership

Other reasons - specify:

Other reasons - specify: Description

Details on this business's locations - Question identifier:5

What was the reason(s) for part-year operation? Select all that apply.

.

How many locations?

Details on this business's locations - Question identifier:6

Were there any other business locations not listed that were operating during the reporting period?

Details on this business's locations - Question identifier:7

Please provide the business location address.

Operating name:

Address (number and street):

City:

Province, territory:

  • 1: Alberta
  • 2: British Columbia
  • 3: Manitoba
  • 4: New Brunswick
  • 5: Newfoundland and Labrador
  • 6: Nova Scotia
  • 7: Northwest Territories
  • 8: Nunavut
  • 9: Ontario
  • 10: Prince Edward Island
  • 11: Quebec
  • 12: Saskatchewan
  • 13: Yukon Territory

Postal code: Example: A9A 9A9

Total operating revenue:

Details on this business's locations - Question identifier:8

Was this additional business location operational for the full year?

  • 1: Yes, full-year operation
  • 2: No, part-year operation OR non-operational

Details on this business's locations - Question identifier:9

Statistics Canada reviews all feedback. We invite your comments pertaining to this additional business location.

Details on this business's locations - Question identifier:10

What were this additional location's part year start and end dates?

Part Year Operation Start Date: Example: YYYY-MM-DD

Part Year Operation End Date: Example: YYYY-MM-DD

Details on this business's locations - Question identifier:11

What was the reason(s) for part-year operation for this additional location? Select all that apply.

Seasonal operation

Ceased operations

New store

Temporarily closed

Change of fiscal year

Moved

Change of ownership

Other reasons - specify:

Other reasons - specify: Description

Changes and events that affected the business or organization

Indicate any changes or events that affected the reported values for this business or organization, compared with the last reporting period. Select all that apply.

  • 1: Strike or lock-out
  • 2: Exchange rate impact
  • 3: Price changes in goods or services sold
  • 4: Contracting out
  • 5: Organisational change
  • 6: Price changes in labour or raw materials
  • 7: Natural disaster
  • 8: Recession
  • 9: Change in product line
  • 10: Sold business units
  • 11: Expansion
  • 12: New/lost contract
  • 13: Plant Closures
  • 14: Acquisition of business units
  • 15: Other changes or events - specify:
  • 16: Other changes or events - specify: (description)
  • 17: No changes or events

Contact person

Contact person - Question identifier:1

Who is the best person to contact about this questionnaire?

First name:

Last name:

Title:

Email address:

Telephone number (including area code):

Extension number (if applicable):

Fax number (including area code):

Feedback

Feedback - Question identifier:1

How long did it take to complete this questionnaire? Include time spent gathering the necessary information.

Hours

Minutes

Feedback - Question identifier:2

We invite your comments about this questionnaire.

Date modified: