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Submitted by Mike Gander on Fri, 05/30/2008 - 06:37.

Thank you for Pre-registering with emagineGreen™!

Please complete the short 14-question survey below.
(Estimated time required to complete the survey is less than 3 minutes.)

Our Privacy Policy: All data collected is confidential and will be used solely by emagineGreen™ to provide the most relevant educational materials and product selection possible at our workshops.

Name:

Please RSVP:

Yes! I am coming to the emagineGreen Workshop™

Sorry, I am not able to come

I might be able to make it to the Workshop

greenCoach:

Who is your emagineGreen Workshop™ greenCoach?

Workshop date:

Zip Code:

Gender:

Female

Male

Age:

20 - 25 years

26 - 30 years

31 - 35 years

36 - 40 years

41 - 45 years

46 - 50 years

51 - 55 years

56 - 60 years

60+ years

Education:

High school

Some college

Undergraduate degree

Graduate degree

Post graduate degree

Children:

Yes

No

Does your household include children?

Children age:

0 - 4 years

5 - 7 years

8 - 12 years

13 - 15 years

16 - 18 years

If yes, what age? (Please check all that apply)

Pets:

Yes

No

Does your household include pets?

How did you hear about emagineGreen™?:

Friends or Family

Web search

Newspaper

Magazine

Television

Radio

Other

In your home, do you

Recycle empty food containers (soda cans, plastic milk cartons, etc.):

Always

Often

When it's convenient

Almost never

Never

Avoid using paper plates and napkins in your home:

Always

Often

When it's convenient

Almost never

Never

Compost:

Always

Often

When it's convenient

Almost Never

Never

Buy organically grown food:

Always

Often

When it's convenient

Almost Never

Never

Donate money to an environmental cause:

Always

Often

When it's convenient

Almost Never

Never

Bring your own bags to the grocery store:

Always

Often

When it's convenient

Almost Never

Never

Encourage elected officials to pass laws to protect the environment:

Always

Often

When it's convenient

Almost Never

Never

Do you consider the impact your purchases have on the environment?:

Always

Often

When it's convenient

Almost Never

Never

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