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Grid Questions with Overall Require Setting

Checkboxes/Multi Select Questions

1. How often do you use social media: *This question is required.

Space Cell	Never	Rarely	Sometimes	Often	Always
Facebook	Facebook: Never	Facebook: Rarely	Facebook: Sometimes	Facebook: Often	Facebook: Always
Twitter	Twitter: Never	Twitter: Rarely	Twitter: Sometimes	Twitter: Often	Twitter: Always
Linkedin	Linkedin: Never	Linkedin: Rarely	Linkedin: Sometimes	Linkedin: Often	Linkedin: Always
Google+	Google+: Never	Google+: Rarely	Google+: Sometimes	Google+: Often	Google+: Always

2. At which meals are the food groups represented in your diet? *This question is required.

Space Cell	Breakfast	Lunch	Dinner	Snacks
Fruits	Fruits: Breakfast	Fruits: Lunch	Fruits: Dinner	Fruits: Snacks
Vegetables	Vegetables: Breakfast	Vegetables: Lunch	Vegetables: Dinner	Vegetables: Snacks
Grains	Grains: Breakfast	Grains: Lunch	Grains: Dinner	Grains: Snacks
Proteins	Proteins: Breakfast	Proteins: Lunch	Proteins: Dinner	Proteins: Snacks
Dairy	Dairy: Breakfast	Dairy: Lunch	Dairy: Dinner	Dairy: Snacks

3. How many calories did you consume for each meal of the day this week? *This question is required.

Space Cell	Breakfast	Lunch	Dinner	Snacks
Monday	Monday: Breakfast	Monday: Lunch	Monday: Dinner	Monday: Snacks
Tuesday	Tuesday: Breakfast	Tuesday: Lunch	Tuesday: Dinner	Tuesday: Snacks
Wednesday	Wednesday: Breakfast	Wednesday: Lunch	Wednesday: Dinner	Wednesday: Snacks
Thursday	Thursday: Breakfast	Thursday: Lunch	Thursday: Dinner	Thursday: Snacks
Friday	Friday: Breakfast	Friday: Lunch	Friday: Dinner	Friday: Snacks
Saturday	Saturday: Breakfast	Saturday: Lunch	Saturday: Dinner	Saturday: Snacks
Sunday	Sunday: Breakfast	Sunday: Lunch	Sunday: Dinner	Sunday: Snacks

4. How many of the below products have you purchased in the past year? *This question is required.

Blue-Rays/DVDs
Movie Posters
Candy

5. When do you eat breakfast, lunch and dinner on weekdays and weekends? *This question is required.

Space Cell	Breakfast	Lunch	Dinner
Monday-Friday	Monday-Friday: Breakfast	Monday-Friday: Lunch	Monday-Friday: Dinner
Saturday and Sunday	Saturday and Sunday: Breakfast	Saturday and Sunday: Lunch	Saturday and Sunday: Dinner

6. Please rate our customer service reps on the below characteristics: *This question is required.

Space Cell	Friendliness	Knowledge	Helpful
Service Rep 1	Reset star selection 1 out of 5 stars for Service Rep 1: Friendliness 2 out of 5 stars for Service Rep 1: Friendliness 3 out of 5 stars for Service Rep 1: Friendliness 4 out of 5 stars for Service Rep 1: Friendliness 5 out of 5 stars for Service Rep 1: Friendliness	Reset star selection 1 out of 5 stars for Service Rep 1: Knowledge 2 out of 5 stars for Service Rep 1: Knowledge 3 out of 5 stars for Service Rep 1: Knowledge 4 out of 5 stars for Service Rep 1: Knowledge 5 out of 5 stars for Service Rep 1: Knowledge	Reset star selection 1 out of 5 stars for Service Rep 1: Helpful 2 out of 5 stars for Service Rep 1: Helpful 3 out of 5 stars for Service Rep 1: Helpful 4 out of 5 stars for Service Rep 1: Helpful 5 out of 5 stars for Service Rep 1: Helpful
Service Rep 2	Reset star selection 1 out of 5 stars for Service Rep 2: Friendliness 2 out of 5 stars for Service Rep 2: Friendliness 3 out of 5 stars for Service Rep 2: Friendliness 4 out of 5 stars for Service Rep 2: Friendliness 5 out of 5 stars for Service Rep 2: Friendliness	Reset star selection 1 out of 5 stars for Service Rep 2: Knowledge 2 out of 5 stars for Service Rep 2: Knowledge 3 out of 5 stars for Service Rep 2: Knowledge 4 out of 5 stars for Service Rep 2: Knowledge 5 out of 5 stars for Service Rep 2: Knowledge	Reset star selection 1 out of 5 stars for Service Rep 2: Helpful 2 out of 5 stars for Service Rep 2: Helpful 3 out of 5 stars for Service Rep 2: Helpful 4 out of 5 stars for Service Rep 2: Helpful 5 out of 5 stars for Service Rep 2: Helpful
Service Rep 3	Reset star selection 1 out of 5 stars for Service Rep 3: Friendliness 2 out of 5 stars for Service Rep 3: Friendliness 3 out of 5 stars for Service Rep 3: Friendliness 4 out of 5 stars for Service Rep 3: Friendliness 5 out of 5 stars for Service Rep 3: Friendliness	Reset star selection 1 out of 5 stars for Service Rep 3: Knowledge 2 out of 5 stars for Service Rep 3: Knowledge 3 out of 5 stars for Service Rep 3: Knowledge 4 out of 5 stars for Service Rep 3: Knowledge 5 out of 5 stars for Service Rep 3: Knowledge	Reset star selection 1 out of 5 stars for Service Rep 3: Helpful 2 out of 5 stars for Service Rep 3: Helpful 3 out of 5 stars for Service Rep 3: Helpful 4 out of 5 stars for Service Rep 3: Helpful 5 out of 5 stars for Service Rep 3: Helpful

7. Please rank the following ice cream flavors. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.

	1	2	3	4	5	6
Chocolate	Rank Chocolate as 1 out of 6	Rank Chocolate as 2 out of 6	Rank Chocolate as 3 out of 6	Rank Chocolate as 4 out of 6	Rank Chocolate as 5 out of 6	Rank Chocolate as 6 out of 6
Vanilla	Rank Vanilla as 1 out of 6	Rank Vanilla as 2 out of 6	Rank Vanilla as 3 out of 6	Rank Vanilla as 4 out of 6	Rank Vanilla as 5 out of 6	Rank Vanilla as 6 out of 6
Strawberry	Rank Strawberry as 1 out of 6	Rank Strawberry as 2 out of 6	Rank Strawberry as 3 out of 6	Rank Strawberry as 4 out of 6	Rank Strawberry as 5 out of 6	Rank Strawberry as 6 out of 6
Rocky Road	Rank Rocky Road as 1 out of 6	Rank Rocky Road as 2 out of 6	Rank Rocky Road as 3 out of 6	Rank Rocky Road as 4 out of 6	Rank Rocky Road as 5 out of 6	Rank Rocky Road as 6 out of 6
Mint Chocolate Chip	Rank Mint Chocolate Chip as 1 out of 6	Rank Mint Chocolate Chip as 2 out of 6	Rank Mint Chocolate Chip as 3 out of 6	Rank Mint Chocolate Chip as 4 out of 6	Rank Mint Chocolate Chip as 5 out of 6	Rank Mint Chocolate Chip as 6 out of 6
Cookies and Cream	Rank Cookies and Cream as 1 out of 6	Rank Cookies and Cream as 2 out of 6	Rank Cookies and Cream as 3 out of 6	Rank Cookies and Cream as 4 out of 6	Rank Cookies and Cream as 5 out of 6	Rank Cookies and Cream as 6 out of 6

8. Please provide us with your contact info: *This question is required.

First Name

Last Name

Email Address

Phone Number

9. Please provide the following information to help us prepare for your trip: *This question is required.

First Name

Last Name

What service do you need?

Departure Date

calendar

Return Date

calendar