FORMS EXAMPLE: An old, out-of-date questionnaire (1998)

Last Name, then First Name:
E-Mail address(es):
Local telephone number:
Personal web page URL:

Part I: Please Check As Many As Apply

  1. I have done the following on World Wide Web:

    Browsed Used search engine Printed pages Downloaded pages Downloaded software Customized browser Viewed source

  2. Which type of web site would you most like to create?

    Personal Informational Recreational Commercial

  3. Which subject areas are the most interesting or important to you?

    Advertising/PR Arts and entertainment Business Crime/law enforcement Economic issues Education Environment/global issues Fashion/clothing Fitness/sports Gender/sexual issues Health/medicine Home/household/architecture International news Mass media Metropolitan New York National news Newark New Jersey Nutrition/diet/cooking Politics Recreation, music, amusement Reform/protest Science/technology Social issues Sports Travel/vacation

  4. What are your special skills or interests in this course (with which you might help others)?
    Writing Editing Research Searching Publishing Promotion Graphics Audio Video/Multimedia Hardware Software Networking Communications Project Management

  5. How do you usually access the Internet/Web:

    Windows 95/98 Windows 3.x DOS Macintosh Unix

  6. Please check the browsers you have used and name your favorite.

    Netscape Internet Explorer Lynx Opera

  7. If you know, what is the version of your browser?

    (unknown) 1 (oldest) 2 3 4 (newest)

  8. Are you familiar with using on-campus Rutgers computers at the:

    Computer labs Library Dorms

  9. Are you able to use off-campus computers regularly at

    Home Family/friends Job or work

  10. Which word processing or desktop publishing software do you use for formatted printing?

    Microsoft Word WordPerfect PageMaker

  11. Which plain text (non-formatting) editors have you used:

    Emacs Notepad PC-Write XyWrite WordStar

  12. Which Windows 95/98 operations or programs have you used ?

    Netscape Internet Explorer Windows Explorer Database Spreadsheet Presentation MS DOS prompt FTP Terminal Telnet Zip programs

  13. Which UNIX (Pegasus) operations or programs are you familiar with?

    E-mail Newgroups Lynx browser Editors (emacs, vi) File management FTP Telnet Zip utilities

  14. Which HTML editors/assistants/aids have you used?

  15. Do you use a commercial online service or internet service provider (ISP), and if so, which?
    (e.g., AOL, Prodigy, Mindspring, AT&T, etc.):

This questionnaire (Part 1) is available online at http://andromeda.rutgers.edu/~ehrlich/465/465-1.html.

Thank you for your patience. When finished, please click on "Submit Entry." Or click on "Clear and Reset" to start over.

Code for the above


<FORM METHOD=post ACTION="http://info.rutgers.edu/cgi-bin/RUInfo/SubmitForm/name=email&url=http://andromeda.rutgers.edu/~ehrlich/465/465-1.html&title=465%20First%20Day:%20Fall_1998&to=ehrlich@andromeda.rutgers.edu">
<p>
<Table border=0>
<TR><TD><font face="Arial, Helvetica">
Last Name, then First Name:
</TD><TD><INPUT NAME="name"  TYPE="text"  VALUE=" "  SIZE="40" ALIGN="left">
<TR><TD><font face="Arial, Helvetica">
E-Mail address(es):
</TD><TD><INPUT NAME="email"  TYPE="text"  VALUE="... @pegasus"  SIZE="50" ALIGN="left">
</TD></TR><TR><TD><font face="Arial, Helvetica">
Local telephone number:
</TD><TD><INPUT NAME="phone"  TYPE="text"  VALUE="973- "  SIZE="20" ALIGN="left">
</TD></TR><TR><TD><font face="Arial, Helvetica">
Personal web page URL:
</TD><TD><INPUT NAME="webpage"  TYPE="text"  VALUE="pegasus.rutgers.edu/~..."  SIZE="50" ALIGN="left">
</TD></TR></TABLE>
<p>
<h3>Part I: Please Check As Many As Apply</h3>
<p>
<OL token="A">
<B><LI>I have done the following on World Wide Web:</b>
<p>
<INPUT NAME="Browsed" TYPE="checkbox">Browsed
<INPUT NAME="Search engine" TYPE="checkbox">Used search engine
<INPUT NAME="Printed pages" TYPE="checkbox">Printed pages
<INPUT NAME="Downloaded pages" TYPE="checkbox">Downloaded pages
<INPUT NAME="Downloaded software" TYPE="checkbox">Downloaded software
<INPUT NAME="Customized browser" TYPE="checkbox">Customized browser
<INPUT NAME="Viewed source" TYPE="checkbox">Viewed source
<p>
<b><LI> Which type of web site would you most like to create?</b>
<P><INPUT NAME="Personal" TYPE="checkbox">Personal
<INPUT NAME="Informational" TYPE="checkbox">Informational
<INPUT NAME="Recreational" TYPE="checkbox">Recreational
<INPUT NAME="Commercial" TYPE="checkbox">Commercial
 <INPUT NAME="Other1" TYPE="text"  VALUE="Other ..."  SIZE="20" ALIGN="left">

<p>
<b><li> Which subject areas are the most interesting or important to you?</b>
<P>
<INPUT NAME="Advertising/PR" TYPE="checkbox">Advertising/PR
<INPUT NAME="Arts and entertainment" TYPE="checkbox">Arts and entertainment
<INPUT NAME="Business" TYPE="checkbox">Business
<INPUT NAME="Crime/law enforcement" TYPE="checkbox">Crime/law enforcement
<INPUT NAME="Economic issues" TYPE="checkbox">Economic issues
<INPUT NAME="Education" TYPE="checkbox">Education
<INPUT NAME="Environment/global issues" TYPE="checkbox">Environment/global issues
<INPUT NAME="Fashion/clothing" TYPE="checkbox">Fashion/clothing
<INPUT NAME="Fitness/sports" TYPE="checkbox">Fitness/sports
<INPUT NAME="Gender/sexual issues" TYPE="checkbox">Gender/sexual issues
<INPUT NAME="Health/medicine" TYPE="checkbox">Health/medicine
<INPUT NAME="Home/household/architecture" TYPE="checkbox">Home/household/architecture
<INPUT NAME="International news" TYPE="checkbox">International news
<INPUT NAME="Mass media" TYPE="checkbox">Mass media
<INPUT NAME="Metropolitan New York" TYPE="checkbox">Metropolitan New York
<INPUT NAME="National news" TYPE="checkbox">National news
<INPUT NAME="Newark" TYPE="checkbox">Newark
<INPUT NAME="New Jersey" TYPE="checkbox">New Jersey
<INPUT NAME="Nutrition/diet/cooking" TYPE="checkbox">Nutrition/diet/cooking
<INPUT NAME="Politics" TYPE="checkbox">Politics
<INPUT NAME="Recreation, music, amusement" TYPE="checkbox">Recreation, music, amusement
<INPUT NAME="Reform/protest" TYPE="checkbox">Reform/protest
<INPUT NAME="Science/technology" TYPE="checkbox">Science/technology
<INPUT NAME="Social issues" TYPE="checkbox">Social issues
<INPUT NAME="Sports" TYPE="checkbox">Sports
<INPUT NAME="Travel/vacation" TYPE="checkbox">Travel/vacation
  <INPUT NAME="Other2" TYPE="text"  VALUE="Other ..."  SIZE="20" ALIGN="left">
<p>
<b><LI> What are your special skills or interests in this course (with which you might help others)?</b><br>
<INPUT NAME="Writing" TYPE="checkbox">Writing
<INPUT NAME="Editing" TYPE="checkbox">Editing
<INPUT NAME="Research" TYPE="checkbox">Research
<INPUT NAME="Searching" TYPE="checkbox">Searching
<INPUT NAME="Publishing" TYPE="checkbox">Publishing
<INPUT NAME="Promotion" TYPE="checkbox">Promotion
<NIPUT NAME="Graphics" TYPE="checkbox">Graphics
<INPUT NAME="Audio" TYPE="checkbox">Audio
<INPUT NAME="Video" TYPE="checkbox">Video/Multimedia
<INPUT NAME="Hardware" TYPE="checkbox">Hardware
<INPUT NAME="Software" TYPE="checkbox">Software
<INPUT NAME="Networking" TYPE="checkbox">Networking
<INPUT NAME="Communications" TYPE="checkbox">Communications
<INPUT NAME="Project Management" TYPE="checkbox">Project Management
<INPUT NAME="Other10" TYPE="text"  VALUE="Other ..."  SIZE="25" ALIGN="left">
<p>
<B><li> How do you usually access the Internet/Web:</B>
<p>
<INPUT NAME="Windows 95/98" TYPE="checkbox">Windows 95/98
<INPUT NAME="Windows 3.x" TYPE="checkbox">Windows 3.x
<INPUT NAME="DOS" TYPE="checkbox">DOS
<INPUT NAME="Macintosh" TYPE="checkbox">Macintosh
<INPUT NAME="Unix" TYPE="checkbox">Unix
<p>
<B><li> Please check the browsers you have used and name your favorite.</b>
<p>
<INPUT NAME="Netscape" TYPE="checkbox">Netscape
<INPUT NAME="Internet Explorer" TYPE="checkbox">Internet Explorer
<INPUT NAME="Lynx" TYPE="checkbox">Lynx
<INPUT NAME="Opera" TYPE="checkbox">Opera
<INPUT NAME="Other3" TYPE="text"  VALUE="Favorite or other..." SIZE="30" ALIGN="left">
<p>
<b><li> If you know, what is the version of your browser? </b>
<p>
<INPUT NAME="0" TYPE="checkbox">(unknown)
<INPUT NAME="1" TYPE="checkbox">1 (oldest)
<INPUT NAME="2" TYPE="checkbox">2
<INPUT NAME="3" TYPE="checkbox">3
<INPUT NAME="4" TYPE="checkbox">4 (newest)
<p>
<B><li> Are you familiar with using on-campus Rutgers computers at the:</B>
<p>
<INPUT NAME="Computer lab" TYPE="checkbox">Computer labs
<INPUT NAME="Library" TYPE="checkbox">Library
<INPUT NAME="Dorm" TYPE="checkbox">Dorms
<INPUT NAME="Other4" TYPE="text"  VALUE="Other ..."  SIZE="20" ALIGN="left">
<p>
<B><li> Are you able to use off-campus computers regularly at</b>
<p>
<INPUT NAME="home" TYPE="checkbox">Home
<INPUT NAME="family" TYPE="checkbox">Family/friends
<INPUT NAME="job" TYPE="checkbox">Job or work
<INPUT NAME="Other5" TYPE="text"  VALUE="Other ..." SIZE="20" ALIGN="left">
<P>
<b><li> Which word processing or desktop publishing software do you use for formatted printing?</B><p>
<INPUT NAME="Microsoft Word" TYPE="checkbox">Microsoft Word
<INPUT NAME="WordPerfect" TYPE="checkbox">WordPerfect
<INPUT NAME="PageMaker" TYPE="checkbox">PageMaker
<INPUT NAME="Other6" TYPE="text" VALUE="Other ..." SIZE="25" ALIGN="left">
<p>
<B><li> Which plain text (non-formatting) editors have you used:</B><p>
<INPUT NAME="Emacs" TYPE="checkbox">Emacs
<INPUT NAME="Notepad" TYPE="checkbox">Notepad
<INPUT NAME="PC-Write" TYPE="checkbox">PC-Write
<INPUT NAME="XyWrite" TYPE="checkbox">XyWrite
<INPUT NAME="WordStar" TYPE="checkbox">WordStar
<INPUT NAME="Other7" TYPE="text"  VALUE="Other ..." SIZE="25" ALIGN="left">
<p>
<B><li> Which Windows 95/98 operations or programs have you used ?</B><p>
<INPUT NAME="Netscape" TYPE="checkbox">Netscape
<INPUT NAME="Internet Explorer" TYPE="checkbox">Internet Explorer
<INPUT NAME="Windows Explorer" TYPE="checkbox">Windows Explorer
<INPUT NAME="Database" TYPE="checkbox">Database
<INPUT NAME="Spreadsheet" TYPE="checkbox">Spreadsheet
<INPUT NAME="Presentation" TYPE="checkbox">Presentation
<INPUT NAME="MS DOS prompt" TYPE="checkbox">MS DOS prompt
<INPUT NAME="FTP" TYPE="checkbox">FTP
<INPUT NAME="Terminal" TYPE="checkbox">Terminal
<INPUT NAME="Telnet" TYPE="checkbox">Telnet
<INPUT NAME="Zip programs" TYPE="checkbox">Zip programs
<p>
<B><LI> Which UNIX (Pegasus) operations or programs are you familiar with?</B><p>
<INPUT NAME="E-mail" TYPE="checkbox">E-mail
<INPUT NAME="Newgroups" TYPE="checkbox">Newgroups
<INPUT NAME="Lynx browser" TYPE="checkbox">Lynx browser
<INPUT NAME="Editors" TYPE="checkbox">Editors (emacs, vi)
<INPUT NAME="File management" TYPE="checkbox">File management
<INPUT NAME="FTP" TYPE="checkbox">FTP
<INPUT NAME="Telnet" TYPE="checkbox">Telnet
<INPUT NAME="Zip utilities" TYPE="checkbox">Zip utilities
<p>
<B><LI> Which HTML editors/assistants/aids have you used?</B><br>
<INPUT NAME="HTMLed" TYPE="text" VALUE="Editors ..."  SIZE="25" ALIGN="left">
<p>
<B><LI> Do you use a commercial online service or internet service provider (ISP), and if so, which?</B><br>
(e.g., AOL, Prodigy, Mindspring, AT&T, etc.):
<INPUT NAME="ISP" TYPE="text" VALUE=" " SIZE="25" ALIGN="left">
<p>

</ol>
<p>
<P>
This questionnaire (Part 1) is available online at <I>http://andromeda.rutgers.edu/~ehrlich/465/465-1.html</I>.
<p>
Thank you for your patience.  When finished, please click on
"Submit Entry."  Or click on "Clear and Reset" to start over.
<p>
<INPUT TYPE="submit" VALUE="Submit entry">
<INPUT TYPE="reset" VALUE="Clear and reset">
</FORM></BODY></HTML>