Amerisure Video SurveyAmerisure Video Survey

Please candidly answer the following questions. Your answers will be anonymous. Your feed back is very important to us and we thank you for your participation.

1

Please select your age range:

18-24

25-34

35-44

45-54

55+

2

Please select your gender:

Male

Female

3

Please select the state in which you live:

4

Please indicate the metropolitan area in which you live:

5

Had you previously heard of Amerisure?

Yes

No

If you answered "No" to question 5, please skip to question 7.

If you answered "Yes" to question 5, please answer question 6.

6

How familiar are you with Amerisure?

Not at all familiar

Slightly familiar

Moderately familiar

Very familiar

Extremely familiar

7

Based on what you saw in the video, please select how likely you are to:

	Not likely at all	Slightly likely	Moderately likely	Very likely	Completely likely
Visit the Amerisure website.	* Based on what you saw in the video, please select how likely you are to: Visit the Amerisure website. Not likely at all	Visit the Amerisure website. Slightly likely	Visit the Amerisure website. Moderately likely	Visit the Amerisure website. Very likely	Visit the Amerisure website. Completely likely
Contact Amerisure for more information.	Contact Amerisure for more information. Not likely at all	Contact Amerisure for more information. Slightly likely	Contact Amerisure for more information. Moderately likely	Contact Amerisure for more information. Very likely	Contact Amerisure for more information. Completely likely
Apply for a job at Amerisure.	Apply for a job at Amerisure. Not likely at all	Apply for a job at Amerisure. Slightly likely	Apply for a job at Amerisure. Moderately likely	Apply for a job at Amerisure. Very likely	Apply for a job at Amerisure. Completely likely

8

Do you agree or disagree with the following statements:

	Strongly disagree	Somewhat disagree	Neither agree nor disagree	Somewhat agree	Strongly agree
I learned more information about Amerisure.	* Do you agree or disagree with the following statements: I learned more information about Amerisure. Strongly disagree	I learned more information about Amerisure. Somewhat disagree	I learned more information about Amerisure. Neither agree nor disagree	I learned more information about Amerisure. Somewhat agree	I learned more information about Amerisure. Strongly agree
My impression of Amerisure improved.	My impression of Amerisure improved. Strongly disagree	My impression of Amerisure improved. Somewhat disagree	My impression of Amerisure improved. Neither agree nor disagree	My impression of Amerisure improved. Somewhat agree	My impression of Amerisure improved. Strongly agree
Amerisure fulfills what I am looking for in a career.	Amerisure fulfills what I am looking for in a career. Strongly disagree	Amerisure fulfills what I am looking for in a career. Somewhat disagree	Amerisure fulfills what I am looking for in a career. Neither agree nor disagree	Amerisure fulfills what I am looking for in a career. Somewhat agree	Amerisure fulfills what I am looking for in a career. Strongly agree
Amerisure is a place I would want to work.	Amerisure is a place I would want to work. Strongly disagree	Amerisure is a place I would want to work. Somewhat disagree	Amerisure is a place I would want to work. Neither agree nor disagree	Amerisure is a place I would want to work. Somewhat agree	Amerisure is a place I would want to work. Strongly agree