Please provide the following contact information:

Name
Title
Organization
Number of Employees
Street Address
Address (cont.)
City
Country
Work Phone
FAX
E-mail

What Company are you employed with?
Country	Please Choose One... Antigua Abguilla Aruba Belize Barbados Caymen Islands Curacao/Bonair Dominica Greneda Guyana MOnserrat S.t Kitts/Nevis St. Lucia St. Vincent Trinidad & Tobago Other
Specify if Other
What is your age?
What is your sex?	Male Female
Do you like the convenience of wearing a uniform?	YES  NO
Do you like the style of your present uniform?	YES  NO
Is the fabric durable and easy to maintain?	YES  NO
Which Alteration Package did your Company select?	MinimumMultiple
Do your uniforms fit well?	YES  NO
Was the representative who measured you friendly and helpful?	YES  NO
Would you prefer Janouras Custom Design as the supplier of your next uniform issue?	YES  NO