Mike's Philmont Survey

Notice: This form does work. It may appear not to but it does. Only push "submit" once and the survey will be sent. I have received up to 11 copies of the same survey from people who think its not working, but it is!

 

Please fill out my Survey

1)Please tell me your name: (Do not hit return)

2)Please tell me your e-mail address

3)Please tell me your URL (homepage) address

4)What state do you live in, or if outside of the US, what country?

5) How old are you?

6) How often do you visit my page?

Every Day
Once per week
Once per month
Once per year

7) Have you been to Philmont before?

Yes, I have
No, I haven't
I want/plan to go in the future
I'm too lazy for Philmont

8) I you have been to Philmont before breifly desrcibe the experience?

9) How could I improve my page?

10) If you homepage is ralated to Philmont could I post it on my site?

Yes
No
11) How did you find my site?

Search Engine
Banner
Webring
From a friend
Other (please specify)

Notice: This form does work. It may appear not to but it does. Only push "submit" once and the survey will be sent. I have received up to 11 copies of the same survey from people who think its not working, but it is!

Click Here!