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Food Survey

You are about to partake in a survey about your food preferences. The purpose of this survey is to get peoples preferences on a new line of products we are releasing. Your feedback will help us improve our product so everyone can enjoy them.

Background Information
Name:
Phone: () -
Address:
City:
State:
Zip:
DOB:
Gender: Male         Female
Internet experience (in years):

Survey Questions
What is your favorite meal?
What is your favorite desert?
Do you like spicy foods? Yes    No
How many meals per day do you eat? 1    2    3     More than 3
How often do you eat out per week? 1    2    3     More than 3
Do you eat a lot of fruit?

Strongly disagree
Somewhat disagree
Neutral
Somewhat agree
Strongly agree
Do you eat a lot of vegetables?

Strongly disagree
Somewhat disagree
Neutral
Somewhat agree
Strongly agree
Do you eat a lot of meat?

Strongly disagree
Somewhat disagree
Neutral
Somewhat agree
Strongly agree
Which of these meals do you like? (Choose all that apply)

Tacos
Burgers
Pizza
Pasta
Chicken
Which of these restaurants do you like? (Choose all that apply)

McDonalds
Wendy's
Pita Pit
Mennas
Subway

Comments
Do you have any comments or additional information for us?


Thank You
Thank you very much for taking our short survey, your results will help us improve our products to better meet our customers demands.
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Contact Info:clark.m.olmsted@wmich.edu © Clark Olmsted 2009