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Simply click here to take the survey. Or you may Copy and Paste the survey below, completely fill it out, and send it to the e mail link below for your free sample!  You may also print this page and mail it to us at:

 

Culture Media &Supplies

118D Kirkland Circle

Oswego, IL  60543

 

THE SURVEY

 

Name:

Title:

Address:

Phone Number:

E-Mail:

 

What media are you using?

 

Do you prepare the media yourself? Does a staff member?

 

What form is the media in? (select all that apply)

                 a. 100X15 Plates

                 b. Other size plates ______

                c. Bottles

                d. Slants

                e. Contact Plates

                f. Tubes

                g. Dehydrated

 

How many do you purchase at a time?

 

How often do you purchase prepared media?  When was the last time your purchased culture media?

 

Where do you normally purchase prepared media?

 

Would you like a free sample with a quote included?

 

 

  

 

 

To copy the survey, highlight the survey with your mouse and right click on your mouse and choose "COPY".  After you click below, when your cursor is in the body of your e mail, right click again and choose "PASTE".  The survey will appear in your e mail!

 

Click here to email us the results!

or send results to Info@Culturemediasupplies.com

All questions must be answered in order to qualify for the free sample.