Survey for Surfing the Internet class

Please fill out this survey, your participation is greatly appreciated.
If you've already taken the course please make a note in the comments.

Your name:	Your email address:
Have you used the Internet? Yes No	Have you used e-mail? Yes No
Do you have Internet access in your home? Yes No	What kind of Internet access do you have? dial up DSL cable none
What skill level would you consider yourself? Never used Beginner Advanced beginner Intermediate Advanced	What are the 2 main things you use the Internet for?
Have you bought anything through the Internet? Yes No
Are there any specific things you want to learn in this course?