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Surveys
2011
June
I
Introduction Questions
Introduction Questions
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Name
Age
Birth Day (Month and Day)
Place of Birth
Current State of residence
Favorite Color
Number of Children
Years Married
Anniversary Date
Do you have any pets?
Yes
No
What types of pets do you own or would you own for those that are petless (Select all that apply)?
Dog
Cat
Rodent
Bird
Snake
Other
Please list 3 personal goals:
Please list 3 professional goals:
What motivates you: (i.e. money, gifts, awards, promotion opportunities, etc.)
What motivates you?
Not at all Motivated
Some What Motivated
Neutral
Motivated
Very Motivated
Money
Movie Gift Certificates
Restaurant Gift Certificates
Candy and Treats
Flowers
More training / responsibility
Paid time off
Favorite Cake:
Favorite Ice cream:
Favorite Candy bar or Candy:
Favorite Local restaurant:
Favorite Music:
Most checked email address?
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