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Require Individual Rows

1. How many calories did you consume for each meal of the day this week?
Space Cell BreakfastLunchDinnerSnacks
Monday *This question is required
Tuesday *This question is required
Wednesday *This question is required
Thursday *This question is required
Friday *This question is required
Saturday *This question is required
Sunday *This question is required
2. At which meals are the food groups represented in your diet?
Space Cell BreakfastLunchDinnerSnacks
Fruits *This question is required
Vegetables *This question is required
Grains *This question is required
Proteins *This question is required
Dairy *This question is required
3. How often do you use social media:
Space Cell NeverRarelySometimesOftenAlways
Facebook *This question is required
Twitter *This question is required
Linkedin *This question is required
Google+ *This question is required
4. How many of the below products have you purchased in the past year?
*This question is required
*This question is required
*This question is required
5. When do you eat breakfast, lunch and dinner on weekdays and weekends?
Space Cell BreakfastLunchDinner
Monday-Friday *This question is required
Saturday and Sunday *This question is required
6. Please rate our customer service reps on the below characteristics:
Space Cell FriendlinessKnowledgeHelpful
Service Rep 1 *This question is required
Service Rep 2 *This question is required
Service Rep 3 *This question is required
7. For each Car Repair Company garage you have visited in the past 12 months please indicate the following:
  • whether you were satisfied with your experience
  • all service received (check all)
  • the service rep who helped you
Were you satisfied
with the service?		 What services did you receive (check all) Service Rep
Yes No Oil change Tire repair Brakes Other
Garage 1 *This question is required
Garage 2 *This question is required
Garage 3 *This question is required
8. Please rate the President on the following traits:
123456
Strong *This question is required Weak *This question is required
Decisive *This question is required Indecisive *This question is required
Good *This question is required Bad *This question is required
Active *This question is required Passive *This question is required
Industrious *This question is required Lazy *This question is required
Happy *This question is required Sad *This question is required
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