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Sunshine Webpage Design

Information Survey


The purpose of this survey is to collect information from you about your hobbies and how you would like to have your personal webpage designed.

This survey is divided into the following sections:

Fill out the information in each section as requested. Then at the end of the form supply your name and contact information, and submit the form. You will receive a confirmation message from us shortly.


SECTION A -- Title of this section

  1. What is your favorite TV show if any?



  2. How many hours of television do you watch per week:

    None 1-5 hours 5-10 hours 10-20 hours More than 20 hours

  3. We would like to send you some literature. What is your mailing address? Your address will not be handed out or sold to anyone!
    Name     
    Street   
    City     
    State    
    Zip Code  
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SECTION B -- Ranking of the Sunshine Webpage

It will give us an idea how to make pages still more professional looking.

  1. How would you rate Sunshine Webpage Design?

    Bad Poor Fair Good Excellent

  2. What is your favorite color?



  3. Select the subject areas you are most interested in:

    History
    Geography
    Mathematics
    Economics
    Literature

  4. Please choose a username and password for your personalized page.

    Username
    Password
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SECTION C -- Which of the following products would you prefer?

Simply mark the items that you would like to have.

  1. Which of our products do you currently own?
    House     Property     VCR     Animals
    Condo     RV     Car     TV
    Apartment     Truck     Stereo     Motorcycle
    
  2. Please enter any additional comments regarding our designs or services:



  3. Select a month from the following list, which shows 6 elements at a time:

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FORM SUBMISSION

Thank you for taking the time to answer the questions in our survey.

This explains how we plan to use the information you provide to us. We will also explain what benefits you receive from helping us in this way.

 

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Your full name:

Your email address: (e.g.: you@aol.com)

Question


Webpage Designer And Owner Warren Johnson.
Copyright © 1995-2003 [Sunshine Webpage Design]. All rights reserved.
Revised: June 15, 2003.