Name
First Name
Last Name
Email
example@example.com
Rating 1
1
2
3
4
Worst
Best
1 is Worst, 4 is Best
Rating 2
1
2
3
4
Worst
Best
1 is Worst, 4 is Best
Rating 3
1
2
3
4
Worst
Best
1 is Worst, 4 is Best
Total
Submit
Should be Empty: