Company name:*

Who is your current PLUS adviser?*

How do you rate the performance of your PLUS adviser?*

Very Poor
Poor
Neutral
Good
Very Good

Who is your current auditor?*

How do you rate the performance of your auditor?*

Very Poor
Poor
Neutral
Good
Very Good

Who is your current solicitor?*

How do you rate the performance of your solicitor?*

Very Poor
Poor
Neutral
Good
Very Good

Who is your current financial analyst?*

How do you rate the performance of your financial analyst?*

Very Poor
Poor
Neutral
Good
Very Good

Which other analysts do you rate highly?

Who are your current PR consultants?*

How do you rate the performance of your PR consultants?*

Very Poor
Poor
Neutral
Good
Very Good

Have you considered having your shares dual traded on Sharemark?*

Yes
No

Any other comments?

Name*

Position

Address*

Date

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