Food Preference

If you would take a moment of you're time to fill out this information and answer a few questions I would appreciate it greatly.  I'm gathering information about people and their food preference.  You're information and answers will be confidential.  You will not be contacted.  And none of you're information will be given out.

General Information

Date:

Name:

Phone:

-   - 

Address:


State   Zip Code
D.O.B. : Month   Day   Year
Gender: Male   Female
Internet experience: 1-5 years   6-10 years   11 or more years

Questions

Question1: Do you like meat? Yes               No
Question2: You like your food... Hot            Warm         Cold
Question3: Would you rather your food... Grilled          Fried      Baked
Question4: Do you like spicey food? Yes                 No
Question5: Do you eat little portions all day or a few big meals? Little                Big
Question6: Do you eat healthy food? Yes                  No
Question7: Are you a fan of pastas? Yes                  No
Question8: Do you like to go out to eat? Yes                  No
Question9: At home do you eat... At table         By tv Counter
Question10: Favorite kind of food out of... American   Chinese Mexican

Thank you so much for participating in this survey. You're time and effort is appreciated.