Visitor questionnaire: example form

This is the FORM element of my example questionnaire.



<FORM ACTION="http://www.uky.edu/cgi-bin/cgiwrap/~johnr/AnyForm.cgi" METHOD="POST">

<!-- **** Change this to your own email address **** -->
<INPUT TYPE="hidden" NAME="AnyFormTo" VALUE="szs@nospam.net">

<!-- **** Change this to your own Thank You page or Home Page URL **** -->
<INPUT TYPE="hidden" NAME="AnyFormDisplay" VALUE="http://www.netjunk.com/users/websitebyemail/thanks03.html">

<INPUT TYPE="hidden" NAME="AnyFormSubject" VALUE="Visitor questionnaire">

<INPUT TYPE="hidden" NAME="AnyFormFrom" VALUE="AnyForm@nil">

<INPUT TYPE="hidden" NAME="AnyFormMode" VALUE="Mail">

<H2>Site Design</H2>
<BLOCKQUOTE>
<P>Please comment on the <I>design</I> of the site, eg: structure, use of color, etc.
<!-- Change the next sentence to something appropriate to your site -->
My main design objective is <I>accessibility</I>. Your critical opinion will help me achieve it.<BR>
<TEXTAREA NAME="Design Opinion" ROWS="6" COLS="50"></TEXTAREA>
<BR>
&nbsp;</P>
</BLOCKQUOTE>

<H2>Site Content</H2>
<BLOCKQUOTE>
<P>If you are able to, please comment on the <I>content</I> of the site.
<!-- Change the next sentence to something appropriate to your site -->
The purpose of the site is {?????????}. Your critical opinion will help me achieve it.<BR>
<TEXTAREA NAME="Content Opinion" ROWS="6" COLS="50"></TEXTAREA>
<BR>
&nbsp;</P>
</BLOCKQUOTE>

<H2>Site-independent information</H2>
<UL>

<LI>What is your first language?<BR>
<INPUT TYPE="TEXT" NAME="Language" SIZE="30"><BR>
<BR>
</LI>

<LI>What country are you in now?<BR>
<!-- Geographical location affects download speed -->
<INPUT TYPE="TEXT" NAME="Country" SIZE="30"><BR>
<BR>
</LI>

<LI>What day of the week is it now?<BR>
<!-- Day of week affects download speed -->
<SELECT NAME="Day" SIZE="7">
<OPTION>Mon</OPTION>
<OPTION>Tue</OPTION>
<OPTION>Wed</OPTION>
<OPTION>Thu</OPTION>
<OPTION>Fri</OPTION>
<OPTION>Sat</OPTION>
<OPTION>Sun</OPTION> </SELECT>
<BR>
<BR>
</LI>

<LI>What time of day is it where you are?<BR>
<!-- Time affects download speed -->
<INPUT TYPE="TEXT" NAME="Time" SIZE="20"><BR>
<BR>
</LI>

<LI>Which choice best describes download speed from my site?<BR>
<!-- Very important to try to get this sort of feedback -->
<INPUT TYPE="RADIO" NAME="Download" VALUE="Very slow">very slow<BR>
<INPUT TYPE="RADIO" NAME="Download" VALUE="Slow">slow<BR>
<INPUT TYPE="RADIO" NAME="Download" VALUE="OK">OK<BR>
<INPUT TYPE="RADIO" NAME="Download" VALUE="Fast">fast<BR>
<INPUT TYPE="RADIO" NAME="Download" VALUE="Veryfast">very fast<BR>
<BR>
</LI>

<LI>What is your user agent?<BR>
<!-- User agent influences design decisions -->
<INPUT TYPE="RADIO" NAME="Agent" VALUE="NN5">Netscape 5<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="NN4">Netscape 4<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="NN3">Netscape 3<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="NN2">Netscape 2<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="IE5">Internet Explorer 5<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="IE4">Internet Explorer 4<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="IE3">Internet Explorer 3<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="IE2">Internet Explorer 2<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="AOL4">AOL 4<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="AOL3">AOL 3<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="Opera">Opera<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="WebTV">Web TV<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="GetWeb">GetWeb<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="WWW4mail">WWW4Mail<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="Other">Other<BR>
<INPUT TYPE="RADIO" NAME="Agent" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>Normally - is image auto-loading turned on or off?<BR>
<!-- Image loading has major impact on download speed and page appearance -->
<INPUT TYPE="RADIO" NAME="Image loading" VALUE="On">On<BR>
<INPUT TYPE="RADIO" NAME="Image loading" VALUE="Off">Off<BR>
<INPUT TYPE="RADIO" NAME="Image loading" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>Normally - is Javascript turned on or off?<BR>
<!-- Javascript has major impact on download speed and page appearance -->
<INPUT TYPE="RADIO" NAME="Javascript" VALUE="On">On<BR>
<INPUT TYPE="RADIO" NAME="Javascript" VALUE="Off">Off<BR>
<INPUT TYPE="RADIO" NAME="Javascript" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>Normally - is Java turned on or off?<BR>
<!-- Java has major impact on download speed and page appearance -->
<INPUT TYPE="RADIO" NAME="Java" VALUE="On">On<BR>
<INPUT TYPE="RADIO" NAME="Java" VALUE="Off">Off<BR>
<INPUT TYPE="RADIO" NAME="Java" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>Normally - are style-sheets turned on or off?<BR>
<!-- Style sheets have major impact on page appearance -->
<INPUT TYPE="RADIO" NAME="Style sheets" VALUE="On">On<BR>
<INPUT TYPE="RADIO" NAME="Style sheets" VALUE="Off">Off<BR>
<INPUT TYPE="RADIO" NAME="Style sheets" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>Which platform are you using?<BR>
<!-- Platform influences design decisions -->
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Windows 98">Windows 98<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Windows 95">Windows 95<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Windows NT">Windows NT<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Windows 3.x">Windows 3.x<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Macintosh">Macintosh<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="UNIX">UNIX<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="OS/2">OS/2<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="WebTV">WebTV<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Other">Other<BR>
<INPUT TYPE="RADIO" NAME="Platform" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>What is your screen resolution?<BR>
<!-- Screen resolution has major impact on page appearance -->
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">1600*1200<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">1280*1024<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">1152*864 <BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">1024*768<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">800*600<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="WebTV">640*480<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="Other">Other<BR>
<INPUT TYPE="RADIO" NAME="Screen" VALUE="Don't know">Don't know<BR>
<BR>
</LI>

<LI>What is your color density?<BR>
<!-- Color density has major impact on page appearance -->
<INPUT TYPE="RADIO" NAME="Colors" VALUE="32 bit">32 Bit (16.7M)<BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="24 bit">24 Bit (16.7M)<BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="16 bit">16 Bit (65K)<BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="8 bit">8 Bit (256)<BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="4 bit">4 Bit (16) <BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="Other">Other<BR>
<INPUT TYPE="RADIO" NAME="Colors" VALUE="Don't know">Don't know<BR>
<BR>
</LI>
</UL>
<P><INPUT TYPE="SUBMIT" NAME="Submit1" VALUE="Submit"> -------- <INPUT TYPE="RESET" NAME="Reset1"></P>
</FORM>

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