Do you Dare?
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1. Default Section
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1
. Which phone service do you have?
Which phone service do you have?
Alltel
Verizon
Sprint
Other
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2
. Which do you prefer?
Which do you prefer?
Touch-screen
Touch-screen & Keypad
Keypad
I don't have a phone
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3
. How much are you willing to pay for the Dare?
How much are you willing to pay for the Dare?
I don't like the Dare
Any amount
Under 100 dollars
Under 400 dollars
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4
. Where would be the most convient place to purchase the Dare?
Where would be the most convient place to purchase the Dare?
The Verizon store
Wal-mart
Internet
I don't want it!
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5
. Do you feel the need to text while driving?
Do you feel the need to text while driving?
yes I'm always texting
NEVER
sometimes
I have no phone
6
. Do you consider yourself clumsy?
Do you consider yourself clumsy?
Of course
Not really
No
Other
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7
. How have you found out about the Dare?
How have you found out about the Dare?
Commercial
Friend/Family Member
Store
Other
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8
. Do you find it necessary to have service in school?
Do you find it necessary to have service in school?
Always
No i don't
In an emergency
Other
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9
. What makes you want to buy a phone?
What makes you want to buy a phone?
Color
Popularity
Size
Other
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10
. Please enter your information below
Please enter your information below
Name:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
Phone Number:
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