Subscriber Initial Survey
This survey is to collect info about subscribers
Email
*
First Name
*
Last name
*
Familian name (if you have one)
What village or city do you live in?
*
What island or state do you live?
*
What is your zip code
*
What is your occupation
*
What age range do you fall into?
*
Please select a value
18 to 30
31 to 45
46 to 55
56 to 65
66 to 75
76 and over
Gender
*
Please select a value
Male
Female
Non-Binary
How satisfied are you with My Jungle Rules so far?
*
Please select a value
Very Satisfied
Satisfied
Not Satisfied
No opinion
Your Comments
Characters remaining: 400