Order DetailsDays for Score (hidden)This is used to autopopulate the Days for Score column in Airtable. Order ID (hidden)Pricing for Fluency Scores is simple: $500 per company per report. The minimum order is five scores. Complete this order form to initiate the process. Because Fluency Score data is collected longitudinally over a two week period, please allow at least three weeks for your Fluency Score reports to be finalized. Product Name (Hidden)Number of Fluency Scores*Please enter a number greater than or equal to 5.If you have a code, please enter it here: Total $0.00 Order LogisticsPlease list the company names and CEO/Founder email addresses (our point of contact) here.*Click the (+) sign to add another row for another company.Company nameEmail address Please upload a CSV file with the company names and email addresses.*Here is a sample CSV file you can copy and fill in.Accepted file types: csv.When do you need this data?* Date Format: MM slash DD slash YYYY Account DetailsOrganization Name*Name of Primary Contact*Email* Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhoneFinalize your orderHow would you prefer to complete payment?*Credit cardACHCheck by mailOrder Total $0.00