Sample HTML Survey Form

Research Data Management Services

University of Delaware

This page illustrates how to form various components of a survey using HTML forms and the Guestbook CGI script on www.udel.edu.

The purpose of the survey would be stated here at the top of the survey. This survey should take less than 10 minutes to complete.

Some simple demographic information could be collected with radio buttons (e.g., gender, nationality), selection boxes (e.g., date of birth, highest degree attained):

Please tell us a little about yourself.

Gender: Male Female

Date of birth: Month Day Year

Nationality: U.S. Canada Mexico Puerto Rico

Highest degree attained:

The following series of questions ask about your feelings toward your work. Select the answer that is true most of the time.

Strongly
agree		 Agree Neither
agree
nor
disagree		 Disagree Strongly
disagree
The work is very stimulating.
I have a lot of freedom at work.
My supervisor is very demanding of high quality.
The work environment is conducive to creative thinking.

Do you have any additional thoughts on the topic of the survey?

If you would like to have a copy of the final summary results sent to you, please type your e-mail address below: