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Viewer Survey

Please fill out this survey to the best of your ability. Text box answers can be completed by placing the insertion point inside the text box and typing. Radio button and check box answers can be selected by clicking on the label text next to the check box or radio button, or by clicking directly on the check box or radio button. If you need to start over please click the Reset button at the bottom of the page. When you are finished please click the Submit button. The data you submit will be kept confidential and will not be released to third parties.

   
   
E-mail Address
   
   
Please describe what you like about the Internet.
Please describe what you don't like about the Internet.
   
   
Please enter your birth date using this format: MM/DD/YY
   
   
Which of the following electronic devices do you own? (Check all that apply.)

 
CD Player
DVD Player
VCR
Computer

None of the Above

  
   
How many hours do you use the Internet? (Check one.)  
   





 
   
Please indicate your favorite time to use the Internet. (Click the down-pointing arrow and select your favorite time.)  
   
 
   
Select the computer brands you own or have owned in the past. (Hold down the Ctrl key (Windows) or Cmd key (Mac) when making a selection to select more than one brand.)  
   
 
   
Use the Browse button to locate a file and select it for uploading.