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Do You Qualify?

Win a free ½-day onsite Experiencing Lean Six Sigma event for your company’s key executives. To qualify, please fill out and submit the assessment below.

* First Name:

* Last Name:

* Organization:

Title:

* Address:

* City:

* State:

* Zip/ Postal Code:

* Country:

* E-mail:

U.S. Phone:

or International Phone

Type of Industry

Company Size

1.	Our company currently uses Six Sigma or Lean Six Sigma
		Yes
		No

	If YES Our (Lean) Six Sigma program is effective in improving results
		Strongly Disagree
		Disagree
		Neutral
		Agree
		Strongly Agree

	If NO Lean Six Sigma is something our company is interested in
		Strongly Disagree
		Disagree
		Neutral
		Agree
		Strongly Agree

2.	How would you describe the acceptance of Lean Six Sigma within your organization?
		Resistance
		Neutrality
		Pockets of acceptance
		Company-wide acceptance

3.	Our employees have the quantitative skills they need to improve results
		Strongly Disagree
		Disagree
		Neutral
		Agree
		Strongly Agree

4.	We understand and meet our customer's needs
		Strongly Disagree
		Disagree
		Neutral
		Agree
		Strongly Agree

5.	How many formally trained (Lean) Six Sigma Black Belts does your company have?
		0
		1-5
		6-10
		11-20
		21+

6.	How many formally trained (Lean) Six Sigma Green Belts does your company have?
		0
		1-5
		6-10
		11-20
		21+

7.	How many formally trained Champions does your company have?
		0
		1-5
		6-10
		11-20
		21+

How would this ½-day event benefit your company's improvement strategy?

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