Food Survey

Introduction:

The purpose of this survey is to obtain information on the different types of eating habits individuals have. It will help provide us with valuable data on various indivudals eating prefrences, patterns and habits. Please fill out all the below fields to help us get a better understanding of the eating habits individuals have.

Survey:

Date:
Name:
Phone Number:
Address:
Date of Birth
Gender:	Male Female
Internet Experience:
I know how to cook.	Strongly Disagree Disagree Neutral Agree Strongly Agree
I make a meal more than I eat one out.	Strongly Disagree Disagree Neutral Agree Strongly Agree
I eat breakfast everyday.	Strongly Disagree Disagree Neutral Agree Strongly Agree
I try to eat well balanced meal everyday.	Strongly Disagree Disagree Neutral Agree Strongly Agree
I consider myself a healthy eater.	Strongly Disagree Disagree Neutral Agree Strongly Agree
Favorite Meal of the day?	Breakfast Lunch Dinner
How many times a week do you eat fast food?	0-1 2-4 4-7 7 or more
Favorite Food Type(s):	Itlian Middle Eastern French Mexican Chinese Other
Favorite Meal?
Comments:

Thank you:

Thank you for taking the time to complete this survey. This information will be very helpful in giving us some insight into America's eating habits.

(annoucments)

j6gay@wmich.edu