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<form method="post" name="phpesp_response" action="http://kidconfidence.com/interact/index.php"> <input type="hidden" name="referer" value=""> <input type="hidden" name="direct" value="1"> <input type="hidden" name="userid" value="38.103.63.60"> <input type="hidden" name="sid" value="5"> <input type="hidden" name="rid" value="0"> <input type="hidden" name="sec" value="1"> <input type="hidden" name="name" value="feedback01"> <table class="headerGraphic"> <tr> <td class="image"></td> </tr> </table> <h2 class="surveyTitle">KidConfidence Feedback Form</h2> <h3 class="surveySubtitle">We'd like to hear your opinion!</h3> <blockquote class="addInfo"></blockquote> <blockquote class="message"></blockquote> <table class="mainTable"> <tbody> <tr> <td class="preQuestionBorder" > </td> </tr> <tr> <td height="62" vAlign=top> <table class="qnOuterTable" width="100%" cellspacing="1"> <tr> <td width="100%" height="60" valign="top"> <table class="qnInnerTable" width="100%" cellPadding="10" cellSpacing="1"> <tr> <td class="qnInnerTd" rowspan="2" vAlign="top"> <A NAME="Q1">1.</A></td> <td class="qnInner"> Please rate the following items </td> </tr> <tr> <td class="qnType"> <blockquote> <table border="0" cellspacing="1" cellpadding="0"> <tbody> <tr> <td class="qnType"></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType">1</td> <td width="40" align="center" bgcolor="#dddddd" class="qnType">2</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType">3</td> <td width="40" align="center" bgcolor="#dddddd" class="qnType">4</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType">5</td> </tr> <tr> <td align="right" class="qnType">Design</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_93" value="0" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_93" value="1" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_93" value="2" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_93" value="3" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_93" value="4" /></td> </tr> <tr> <td align="right" class="qnType">Navigation</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_94" value="0" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_94" value="1" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_94" value="2" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_94" value="3" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_94" value="4" /></td> </tr> <tr> <td align="right" class="qnType">Overall Ease of Use</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_95" value="0" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_95" value="1" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_95" value="2" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_95" value="3" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_95" value="4" /></td> </tr> <tr> <td align="right" class="qnType">Quality of Content</td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_96" value="0" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_96" value="1" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_96" value="2" /></td> <td width="40" align="center" bgcolor="#dddddd" class="qnType"><input type="radio" name="39_96" value="3" /></td> <td width="40" align="center" bgcolor="#eeeeee" class="qnType"><input type="radio" name="39_96" value="4" /></td> </tr> </tbody> </table> </blockquote> </td> </tr> </table></td> </tr> </table></td> </tr></tbody> <tbody> <tr> <td class="preQuestionBorder" > </td> </tr> <tr> <td height="62" vAlign=top> <table class="qnOuterTable" width="100%" cellspacing="1"> <tr> <td width="100%" height="60" valign="top"> <table class="qnInnerTable" width="100%" cellPadding="10" cellSpacing="1"> <tr> <td class="qnInnerTd" rowspan="2" vAlign="top"> <A NAME="Q2">2.</A></td> <td class="qnInner"> What other games would you like to see children's reviews for? </td> </tr> <tr> <td class="qnType"> <blockquote> <input type="text" size="30" name="40" /> </blockquote> </td> </tr> </table></td> </tr> </table></td> </tr></tbody> <tbody> <tr> <td class="preQuestionBorder" > </td> </tr> <tr> <td height="62" vAlign=top> <table class="qnOuterTable" width="100%" cellspacing="1"> <tr> <td width="100%" height="60" valign="top"> <table class="qnInnerTable" width="100%" cellPadding="10" cellSpacing="1"> <tr> <td class="qnInnerTd" rowspan="2" vAlign="top"> <A NAME="Q3">3.</A></td> <td class="qnInner"> What other types of content would you like to see? </td> </tr> <tr> <td class="qnType"> <blockquote> <input type="text" size="30" name="41" /> </blockquote> </td> </tr> </table></td> </tr> </table></td> </tr></tbody> <tbody> <tr> <td class="preQuestionBorder" > </td> </tr> <tr> <td height="62" vAlign=top> <table class="qnOuterTable" width="100%" cellspacing="1"> <tr> <td width="100%" height="60" valign="top"> <table class="qnInnerTable" width="100%" cellPadding="10" cellSpacing="1"> <tr> <td class="qnInnerTd" rowspan="2" vAlign="top"> <A NAME="Q4">4.</A></td> <td class="qnInner"> Anything else? </td> </tr> <tr> <td class="qnType"> <blockquote> <textarea name="42" rows="5" cols="60"></textarea> </blockquote> </td> </tr> </table></td> </tr> </table></td> </tr></tbody> <tbody> <tr> <td class="preQuestionBorder" > </td> </tr> <tr> <td height="62" vAlign=top> <table class="qnOuterTable" width="100%" cellspacing="1"> <tr> <td width="100%" height="60" valign="top"> <table class="qnInnerTable" width="100%" cellPadding="10" cellSpacing="1"> <tr> <td class="qnInnerTd" rowspan="2" vAlign="top"> <A NAME="Q5">5.</A></td> <td class="qnInner"> If you'd like us to respond, please leave your email. </td> </tr> <tr> <td class="qnType"> <blockquote> <input type="text" size="30" name="43" /> </blockquote> </td> </tr> </table></td> </tr> </table></td> </tr></tbody> </table> <input type="submit" name="submit" value="Submit Survey"> </form>
