Survey Examples

Customer Support Survey.

A survey can help you understand the needs of your customers, it can also help the customer, as it provides a logical method of supplying information. Don't be surprised if you do not get many replies, as most visitors view and leave, those that complete the form are much more likely to be the type of contact you need. Make certain you reply and communicate as soon as possible. This form sends the details via an email template, the next update will add the information to an MySQL database, which provides better customer support and management control.

Please enter your name, email address and security check all other fields are optional. The more information you supply the better, and will assist in providing a detailed reply. All information to be supplied in English and is considered confidential and will never be sold or passed to a third party without your permission, ever.
Your Name: *
Email Address: *
Confirm your email: *
Type: Exporter   Importer    Local country only
Location:
Company size: 1-10  11-50  51-300  301-1000 
Website URL:
Do you have a Webmaster?: Yes     No
Have you a company Blog?: Yes     No
Do you use a shopping cart?: Yes     No
Do you receive email spam?: Yes     No
Do you need assistance?: Yes     No
Have you a budget?: Yes     No
Would you like reports?: Yes     No
Have you a major competitor?: Yes     No
Would you like free evaluation?: Yes     No
When was the site last updated?:
   
Any other Information:
 
Please supply as much additional information as possible. If  you require telephone contact, please supply the full number including area code.  
Security Check. Add this code Image verification   here
     
  Thank you for completing this form, if you would like a version for your website, please use the normal contact form listed in the menu bar.


Creating a form takes time and knowledge. There is a solution from Google which is free, ok you have to set up and populate
the questionnaire, but it can be very useful. Here is a simple example, please cast your vote so I can see the results.