You are on page 1of 1

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon 8700


Tel (088) 813-5661 to 5663; TeleFax (088) 813-2717, www.buksu.edu.ph
BUKIDNON STATE UNIVERSITY
Name of Office:
I am a : Student Parent Teacher
(Please Check)
C U S T Visitor
OMER FEE D B A C K S
Government Employee U R VEY
Others. Specify ___________________________________

Purpose of visit:

We greatly value your opinion. Please assess your experience with our product or service by checking ( ) the
column that corresponds to your rating using the scale given below:

Rating Area
Very Much Very Moderately Slightly
Not Satisfied
Satisfied Satisfied Satisfied Satisfied

1. Courtesy

2. Accuracy

3. Responsiveness

4. Professionalism
5. How do you rate your over-all experience
with our service?

Please write your compliments, comments or suggestions below:

Thank you for taking time…

Name (Optional): ______________________________________ Date: __________________

Contact Number (Optional): Time:

Document Code: QMS-F-023 Revision No.00 Issue No.01 Issue Date: 07/07/2020 Page 1 of 1

You might also like