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This is a sample form in Word for the Web

 

How old are you?

 

Under 18

Over 25

Between 30-40

40 or higher

 

What’s your favorite TV show?

 

How long have you been a student at NICC?

 

This is my first semester

This is my second semester

This is my second year

More then two years

 

Would you like us to send you more information about continuing your education?

 

Yes

No

 

What is your E-mail address?

 

Put your password here to log into Xpress

 

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