1. How did you first learn of [SITE NAME]? Please select all that apply.
	Recommendation from another person Link from email our site sent you Link from another Web site TV Radio Newspaper Magazine Internet ad Search engine results Social Media Other, please specify

	2. How many times in the last 30 days have you visited [SITE NAME]?
	This is my first visit Daily A few times per week Once per week A few times per month Once per month Have not visited in last 30 days

	3. How likely are you to return in the next 30 days?
	Not likely at all   Neutral   Very likely 1 2 3 4 5

	4. What was your main reason for visiting our site?
	Gather information Curious [ENTER OTHER REASONS] Other, please specify

	5. Approximatly how long were you at [SITE NAME]?
	Under 1 minute 1 - 5 minutes 6 - 10 minutes 11 - 15 minutes 16 - 25 minutes Over 25 minutes

	6. Which Web browser do you use to access the Internet?
	Internet Explorer Google Bing FireFox Safari Don't know Other, please specify

	7. What is your internet access speed?
	56K Cable DSL or ISDN T1 T3 Don't Know

	8. Please indicate your gender:
	Male Female

	9. Please select the category that includes your age:
	17 or younger 18-24 25-34 35-33 34-54 55-64 65 or older

	10. Which one of the following ranges includes your total yearly household income before taxes?
	Under $15,000 $15,000 to $24,999 $25,000 to $34,999 $35,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 $100,000 to $7149,999 $150,000 to $199,999 Over $200,000 Prefer not to answer

	11. What is your zip code?
	Zip

	Thank you for your feedback.