Multiple Choice Questionnaire
Survey Example

Your name, please:

Here is a completely trivial set of questions that ask how often you do something. I'm sure you can think of a more useful set of questions! The values returned with the questions are "1", "2", "3", or "4", but could be any text. When MS Access imports these to numeric fields in a table, they are saved as integers and can be averaged, or used for other statistical purposes.

How often do I:

 Almost
Never
Seldom
Usually		 Almost
Always
1 Read Info-World as opposed to some Ziff-Davis publications?
2 Brush my teeth in the morning?
3 Curse at my computer and then remember it's probably not listening?
4 Get in what I THINK will be the shortest line at the grocery store, only to find that, once again, I've chosen the longest one?
5 Go beyond 5,000 miles between oil changes?
6 Eat weird food, just to be polite?
7 Forget to feed the dog in the morning?
8 Exceed my own expectations in accomplishing a goal?
9 Pay big bucks to see a movie in theatre, that I'd normally never get a video for?
10 Make extra efforts to educate myself about southwestern farm grubs?
11 Realize that I should have had a V-8?
12 Discuss merits of watching "Home Improvement" reruns vs. "Wheel of Fortune" with spouse?
13 Go to Husker football home games?
14 Find myself day dreaming of Puerto Vallarta during January?
15 Have pancakes for breakfast?
16 Do something really nice for someone unexpectedly?