2. Visit Information:
4. What type of contact or interaction did you have?
   -- Select One --Visit to municipal officesTelephone conversationE-mail exchange Written correspondenceOn-site inspection/visitPublic meetingOther (Please specify below)
6. Specify "Other" from the above question
8. What was the reason for this contact or interaction?
10. Which department did you interact with in the borough?
    -- Select One --AdministrationBuilding DepartmentClerk/Public InformationCode Enforcement/Fire Marshal/OEMCourtFinanceFireHuman ResourcesInformation TechnologyLibraryParkingPlanning/ZoningPolicePublic Works/Animal ControlRecreationSenior CenterTax Assessor/CollectorVital Statistics
12. How satisfied were you with the service you received?
    -- Select One --Very SatisfiedSatisfied NeutralDissatisfiedVery Dissatisfied
16. Employee Service:
18. Name of employee(s) who assisted you (if known):
20. Employee Courtesy
    -- Select One --Completely SatisfiedVery SatisfiedSatisfiedSomewhat SatisfiedNot Satisfied
22. Employee Knowledge
    -- Select One --Completely SatisfiedVery SatisfiedSatisfiedSomewhat SatisfiedNot Satisfied
24. Employee Response Time
    -- Select One --Completely SatisfiedVery SatisfiedSatisfiedSomewhat SatisfiedNot Satisfied
26. If you had an appointment, did the borough employee arrive during the scheduled time?

    1. Yes
    2. No
    3. N/A
28. Did the borough employee act in a professional manner?

    1. Yes
    2. No
30. Were your questions/issues addressed in a timely manner?

    1. Yes
    2. No
34. Additional Information:
36. Would you like to be contacted by the Borough Administrator's office?

    1. Yes
    2. No
38. Additional Comments:
42. Contact information:
44. Type of customer
    -- Select One --ResidentBusiness OwnerCommunity OrganizationLand OwnerVendorContractor Other (Please specify below)
46. Specify "Other" from the above question
48. Name
50. Address
52. City
53. State
54. Zip Code
56. Phone Number
57. Fax Number
59. Email Address
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit Submit and Print

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