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Sample Survey
This web survey form demonstrates the online surveying capabilities of SurveyGold. Web survey forms can have all questions displayed on a single page or, like this one, questions can appear on multiple pages.

This form also uses an optional setting the only allows the form to be submitted once by a given respondent.

The respondent data on this page is optional and does not need to be entered to continue.

The confirmation page at the end of the survey can be customized to your liking.


Please provide the following
First Name
Last Name
Email

Created with SurveyGold web survey software - www.surveygold.com


About You
Before we get started, tell us a little about yourself.
Your Gender
Female
Male
Other

Your Role
(Hold down the CTRL key and select all that apply.)

Your Age
17 or less
18-25
26-35
36-45
46-55
56-65
66-75
76 or more

Created with SurveyGold web survey software - www.surveygold.com


About Your Business

How many "employees" are at your location?
1
10 or less
11-50
51-500
501-5000
5001 or more

Created with SurveyGold web survey software - www.surveygold.com


About Your Usage of Our Product

How satisfied are you with our product?
Very Satisfied
Satisfied
Neither
Unsatisfied
Very Unsatisfied

What three things do you like most about our product?

What factors motivated you to purchase our product?
(Select all that apply.)
Price
Value
Brand Name
Recommendation
Readily Available
Other

How likely are you to buy from us again?
Very Unlikely
Unlikely
Neither
Likely
Very Likely

Created with SurveyGold web survey software - www.surveygold.com