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"http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<!--Jonathon Hua, jxh2158-->
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title>Online Survey</title>
<style type="text/css">
h1 {text-align: center}
h2 {text-align: Center}
p {font-size: 12pt;
text-align: center}
body {background-color: pink}
li {font-size: .3em}
div {text-align: left;
font-size: .3em;
margin: .5em}
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.ridge {border-style: ridge;
border-color: darkgreen}
.groove {border-style: groove;
border-color: lightblue}
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</head>
<body>
<h1 style="color: #0000ff">
Thank you for choosing Ouran Host Cafe <br />
</h1>
<div>
<table>
<tr>
<td style="color: #009900">
You have been randomly selected to participate in our Customer Satisfaction Survey.
Please tell us a little bit about yourself by filling in the requested information
at the top of the survey, then respond to the survey opinion statements based on
your experiences with Ouran Host Cafe. To show our appreciation, we will
send you a complimentary velvet cafe voucher for your next visit. You may use the
voucher on your next visit when you request for your host of your choosing. The
voucher will be sent to you by email.
</td>
<td>
<img src="Pic1.jpg" width="256" height="204" alt="cup"/>
</td>
</tr>
</table>
<br />
</div>
<hr />
<form action="#" method="post">
<div style="margin-left: auto; margin-right: auto; text-align:center; color:#996600"><h3 style="color: #006600">
Personal Information</h3>
<br />
First name: <input type="text" name="firstname" />
Last name: <input type="text" name="lastname" /><br />
Email address: <input type="text" name="emailaddress" /><br />
Gender: male <input type="radio" name="sex" value="male" />
female <input type="radio" name="sex" value="female" /><br />
Age Group: Under 21 <input type="radio" name="age" value="under21" />
21-40 <input type="radio" name="age" value="2140" />
Over 40 <input type="radio" name="age" value="over40" />
<br />
</div>
<hr />
<h2 style="color:#000066;">
Please respond to the opinion statements using the following scale:
</h2>
<ul>
<li>1 = Strongly Agree</li>
<li>2 = Somewhat Agree</li>
<li>3 = Neither Agree nor Disagree</li>
<li>4 = Somewhat Disagree</li>
<li>5 = Strongly Disagree</li>
</ul>
<ol>
<li>Ouran Host Cafe had refreshing service.<select><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option></select></li>
<li>The host was well groomed and attentive.<select><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option></select></li>
<li>The tea served had a nice aroma and texture.<select><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option></select></li>
<li>The price was reasonable in comparison to the service and atmosphere.<select><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option></select></li>
<li>I would come back for another visit.<select><option>1</option><option>2</option><option>3</option><option>4</option><option>5</option></select></li>
</ol>
<div>
<input type="submit" value="Submit" /><input type="reset" value="reset" />
</div>
</form>
</body>
</html>