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  2. 2015
  3. March
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  5. Breakfast at West Side Cafe On Us
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Thank you for participating in our Survey sponsored by Nick Martinez Farmers Insurance Agency. By checking the box below you agree to be bound by all rules and regulations.

https://docs.google.com/document/d/1_Pv0X7pdm8LKc9...

#TimetoPickNick

*This Contest is not affiliated with, nor endorsed by, West Side Cafe in any way.
 
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
* What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
* Who is/are your current insurance provider(s) (Select all that apply)?
 
Farmers
 
State Farm
 
Allstate
 
Nationwide
 
Geico
 
Other
 

 
 
How do you feel about the following based on your current insurance provider:
Hate 'Em Indifferent Love 'Em
* Your Personal Agent
* Services Offered
* Website
* Customer Service
* Overall
 
 
 
Please drag and rank (1st to 4th) the following in order of interest:
Drag your choices here to rank them
     
     
     
    What services would you like more information on (Select all that apply)?
     
    Auto Insurance
     
    Home Insurance
     
    Renter's Insurance
     
    Life Insurance
     
    Other
     

     
     
     
    * First Name : 
    * Last Name : 
    Phone : 
    * Email Address : 
     
     
     
    Nick Martinez Farmers Insurance Agency has been a Favorite among insurance providers since 2008! Contact them at (817) 201-2701 or go by the Local Officeat8008 Camp Bowie West, Suite 105, Fort Worth, Texas 76116. Click here to learn more:www.timetopicknick.com
     
    timetopicknick.com