University of Wisconsin-Madison

Disaster Management Center

Home > Course User Survey

Course User Survey

Please enter the security code shown

Security Code is case sensitive.
If security code is off the grid or unreadable refresh your browser.

1. Why are you accessing these courses? Check all that apply:

Need for Job Requirements For Self-Development
Just Curious Found by Accident
Other:

2. How did you learn about these courses? Check all that apply:

By Brochure(s)/Direct Mailing By Email/List Server
On the World Wide Web Personal/Business Contacts
Other:

3. If you have you ever taken an Independent Study, please indicate how. Check all that apply:

Yes, by traditional programs Yes, by Internet programs
Other:

4. How frequently do you use/access the following?

E-MAIL: Never Seldom Daily
Hourly Project by Project

GOPHER: Never Seldom Daily
Hourly Project by Project

WWWeb: Never Seldom Daily
Hourly Project by Project

5. Equipment you use to access the Internet? Computer Type: (Select all that apply)

Windows Apple/Macintosh Unix System
Other:

Modem/Connection Type:(Select all that apply)

14.4K Less than 14.4K 28.8K ISDN Line
DSL Cable Satellite
Other:

6. From where do you access the Internet? Check all that apply.

Company or Business Library or University Home
Other:

7. Please provide us with any recommendations or ideas we can use to improve access to, or the potential of these courses:

8. If you would like more information related to our print courses, or on future Internet courses, please give us your name and mail address. Send Materials by:

Fax E-Mail Surface Mail

*required fields

First Name*:
Middle Initial:
Last Name*: (family name)
Title:
Company:
Mailing Address:
City:
State/Province:	Postal Code: Country:
Phone:	Fax:
Email*:

UW Global Navigation