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Name:*
Street Address:*
City:*
State:*
Zip Code:*
Preferred Method of Contact:*
Preferred Phone Number:
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On a scale of 1 (worst) to 5 (best), how would you rate the following areas?
How promptly were you welcomed?*
Was our staff friendly and were you treated courteously?*
How was our staff's knowledge of our products and services?*
Did we provide adequate information?*
Overall, how satisfied were you with your experience?*
Would you recommend Bank of Blue Valley?*

What additional products or services may we contact you to discuss?
Please check all that apply.
 Performance Checking
 Certificates of Deposit & IRAs
 Personal Loans
 Mortgage & Home Equity Loans
 On-line Banking/ Bill Pay Options
 Wealth Management - Trust Services
 Wealth Management - Brokerage Services
 Master Money Debit Card with Rewards
 Commercial Deposits
 Commercial Lending
 Commercial Equipment Financing
 Commercial Real Estate
 Deposit IT (remote scanning of checks for deposit)
 Merchant MasterCard Services
 Treasury Management Services

Additional Comments:
How can we improve your banking relationship?
What additional products or services would you like Bank of Blue Valley to offer?
Other comments:
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