Sample Survey

Instructions

This web survey form demonstrates the online surveying capabilities of SurveyGold. As you can see, web survey forms support single- and multi-select dropdown menus, checkboxes and single- and multi-line fill-in-the-blank fields, and a matrix of radio buttons. You can make questions and respondent data (e.g., name, email, etc.) in web survey forms required or optional. The first three numbered questions in this survey are required. 

To submit your responses to this survey, click the button at the bottom of the web form. Try submitting the survey without entering responses and then with partial responses to see how SurveyGold handles required questions. Note that you can specify a custom confirmation page to display to your respondents after responses are submitted.


Please provide the following

First Name

Last Name

Email


About You


1.

Your Age


2.

Your Gender

Female

Male

Other


3.

Your Role

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


About Your Business


4.

How many employees are at your location?

1

10 or less

11-50

51-500

501-5000

5001 or more


About Your Usage of Our Product


5.

How satisfied are you with our product?

Very Satisfied

Satisfied

Neither

Unsatisfied

Very Unsatisfied


6.

What three things do you like most about our product?

(Provide up to three responses.)


7.

What factors motivated you to purchase our product?

( Select all that apply.)

Price

Value

Brand Name

Recommendation

Readily Available

Other:


8.

How likely are you to buy from us again?

Very Unlikely

Unlikely

Neither

Likely

Very Likely


Your Opinions

This section shows an example of the matrix presentation style.

 

Strongly Agree

Agree

Neither

Disagree

Strongly Disagree

9.

I like the way the product looks

10.

I like the way the product feels

11.

I like the price of the product



Created with SurveyGold - ©2008 Golden Hills Software, Inc. - http://surveygold.com