Please fill out my Survey

Please tell me your name: (Do not hit return - this will send the form.)

Please enter your e-mail address:

1) How old are you?
2) How often do you visit my page?
Every Day
Every Week
Once per month
Once per year
3) What are your favorite ice cream flavors?
You may select more than one.
Chocolate
Strawberry
Vanilla
Banana
4) Please provide your comments about my page
5) What do you think of this Forms Class?