COMMITTEE ON AGENT ORANGE
AGENT ORANGE SURVEY
From this point on you will be presented with the survey. The survey page works on a counter, so each time the page is accessed it changes the number, which give the person filling out the survey their identification number.
If you start the survey by proceeding to the next page, please complete everything and send the info.
If you simply want to view a portion of the survey to see what the actual survey would look like
click here
.
Please, only got to the Survey if you wish to fill it out. Thank you....
The Survey can take a while to fill out it has 106 Questions with 180 response portions. It has been automated to eliminate writing, with very few questions requiring actual keyboard input, but you do have to point and click to answer the questions.
If you have doubts click on the "click here" above to view a portion of the survey. Please don't let this scare you off, we need your input.
Thanks.
Click here to start the survey
Click here to return to the Agent Orange Page
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VIETNAM VETERANS OF FLORIDA, STATE COALITION
SELECT COMMITTEE ON AGENT ORANGE
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