image, Logo: The Center for Family Enrichment. Creating change together.
REGISTER NOW!
 image, Go! Register Now.
Search

 

  
Online Survey

Thank you for your interest in the Center for Family Enrichment. Please take a few moments to complete the survey below.

  • You will receive one FREE class for completing this survey.
  • By completing this survey you are under no obligation to enroll in a course.

Fields marked with * are required.

First Name

  *

Last Name

  *

Mailing Address

  *

City

  *

State/Province

  *

Zip/Postal Code

  *

Country

  *

Telephone

E-mail

  *
  

Primary Language Spoken in Home

  *

Ethnicity

  *

Relationship Status

  *

Numer of Children
and Ages

Number     *
Age

 

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

Your Age

  *

Gender

Female
Male

Education Years Completed

  *

Occupation

  *

Household Income

  *

  

Computer Platform *

PC/Windows
Mac
Other
Don't Know

Computer Browser *

Internet Explorer v5.5 or Higher
Internet Explorer v5.0 or Lower
Netscape Navigator v6.0 or Higher
Netscape Navigator v4.7 or Lower
America Online
Other
Don't Know

Internet Access Speed *

Dial-Up - 56.6K or Slower
DSL (256K)
Cable/Broadband
T-1/Dedicated Line or Faster
Other
Don't Know

Do you have a microphone connected to your computer?  *   
Yes    No

Do you have a Web camera (so others can see you) connected to your computer?  *   
Yes    No

  

What are the best days of the week for live online classes?   *
Check all that apply.
      Monday
      Tuesday
      Wednesday
      Thursday
      Friday
      Saturday
      Sunday

What are the best times of the day for live online classes?   *
Check all that apply.
      Early Morning - 6 a.m. to 9 a.m.
      Late Morning - 9 a.m. to Noon
      Mid-Day - Noon to 2 p.m.
      Afternoon - 2 p.m. to 5 p.m.
      Early Evening - 5 p.m. to 8 p.m.
      Evening - 8 p.m. to 10 p.m.
      Late Evening - 10 p.m. to 1 a.m.
      Wee Hours - 1 a.m. to 6 a.m.

Your Time Zone     *

What topics would you like our courses to cover?   *

How did you learn about our Website?      *

Do you have additional comments, questions or suggestions?
  

Would you like to be added to the Center for Family Enrichment mailing list?   *
Yes    No

  

The form may take a few seconds to validate. Please hit the Submit button only once.

 

Register   |   Disclaimer   |   Security & Privacy   |   Site Map

 

Copyright © 2009 The Center for Family Enrichment LLC. All rights reserved.
HOME
  ABOUT US  
  ONLINE COURSES  
  CALENDAR  
  FAQs  
  TECH SUPPORT  
  RESOURCES  
  TESTIMONIALS  
  CONTACT US