Data Dashboard Order Form

Employee Feedback Data Dashboard Order Form:

After we have collected the responses from your employees, that data is available for purchase in the Employee Feedback Data Dashboard. Answers will be provided to all questions asked on the employee survey in the form of percentage of positive response. Open ended comments and benchmarking data will also be available. The Data Dashboard is an interactive tool where data can be viewed in charts, graphs and downloadable pre-created report formats. Ordering your report package by March 17, 2025 saves you 15% off the price!

Number of Eligible Fort Worth Employees	Number of Eligible Employees Surveyed	Report Fee with 15% Discount*(discount ends 03/17/25)	Report Fee Regular Pricing*
15-24	All	$855	$1,010
25-99	All	$880	$1,040
100-199	All	$980	$1,155
200-499	Up to 300**	$1,030	$1,215
500-999	400**	$1,100	$1,295
1000 and above	500**	$1,140	$1,345

_{*Costs are not refundable. **Employees are randomly selected.}

Select your number of employees in Fort Worth*

Response required.

Total Fee

0.00 USD

Payment Options

Pay Online

Invoice Me

Billing Contact

Organization Name*

Response required.

First Name*

First name needed.

Last Name*

Last name needed.

Email Address*

Valid email needed.

Phone*

Valid phone needed.

Phone Extension

Invalid

Fax

Valid phone needed.

Billing Address

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Credit Card Information

Credit Card Number

Invalid Input

Card Security Code (CSC)

Invalid Input

Card Expiry Month

Invalid Input

Card Expiry Year

Invalid Input

If the form does not submit, please review your information above to see what is missing or what needs to be corrected.

Prove that you're human*

Response required.