EVENT SURVEY

Question Title

* 1. What is your?

Name

Company Name

City/Town

Phone Number

Question Title

* 2. How many benefit eligible employees do you have?

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* 3. Do you already offer AFLAC benefits to your employees?

Yes

No

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* 4. If "No", I would be interested in finding out more about AFLAC

Yes

No

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* 5. If you offer similar benefits through a different provider would you be interested in obtaining a comparison with AFLAC's latest products?

Definitely would

Definitely would not

We do not currently offer this type of voluntary benefit

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* 6. I am interested in learning more about AFLAC's free Value Added Services

Yes

No

Thank you for completing the survey. Your participation is greatly appreciated!