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<title>Cell Phone Survey</title>
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<!--msthemeseparator--><p align="center"><img src="../_themes/copy-of-blends/blesepa.gif" width="600" height="10"></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><b><font size="6">Town
of Needham</font></b></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><font size="6"><b>Cell
Phone Survey</b></font></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><b><font size="4">
Please respond by September 24, 2004</font></b></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><font size="4"><b> </b></font></p>
<form method="POST" action="../_vti_bin/shtml.dll/xInHouseWebPages/CellPhoneSurvey.htm" onSubmit="" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" S-Email-Format="TEXT/PRE" S-Email-Address="[email protected]" B-Email-Label-Fields="TRUE" S-Date-Format="%d %b %Y" S-Time-Format="%H:%M:%S" S-Builtin-Fields="REMOTE_NAME REMOTE_USER HTTP_USER_AGENT Date Time" S-Form-Fields="Department NameOfRepondent PersonalPhoneUse EmployeePersonalPhoneUse EmployeePersonalPhoneUseQuantity TownProvidedPhone TownPhoneProvider OtherProvider Quantity Description AnnualPrice ContractEndDate " startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" i-checksum="43374" endspan -->
<p><strong>Select Department responding:</strong></p>
<p><select name="Department" size="1">
<option selected>Assessor's Office</option>
<option>Building Department</option>
<option>Comtroller's Office</option>
<option>Conservation Commission</option>
<option>Council On Aging</option>
<option>Department of Health</option>
<option>Enigineering Division</option>
<option>Finance Department</option>
<option>Fire Department</option>
<option>Garage</option>
<option>Highway Division</option>
<option>Library</option>
<option>MIS / Data Processing</option>
<option>Municipal Building Maintenance Department</option>
<option>Park & Recreation</option>
<option>Parks & Forestry</option>
<option>Permanent Building Maintenance Department</option>
<option>Personnel/Benefit Administration</option>
<option>Planning Board</option>
<option>Plice Department</option>
<option>Public Works Department</option>
<option>Retirement Board</option>
<option>Ridge Hill Reservation</option>
<option>School Department</option>
<option>Town Administration</option>
<option>Town Clerk's Office</option>
<option>Transfer Station</option>
<option>Treasurer's Office</option>
<option>Veteran's Office</option>
<option>Youth Commission</option>
<option>Water & Sewer Division</option>
</select></p>
<p><b>Name of Respondent:</b></p>
<p><textarea name="NameOfRepondent" rows="1" cols="42"></textarea></p>
<p><b>Do you use a cell phone for Department business that is paid for with
personal out of pocket funds?:</b></p>
<blockquote>
<p><input type="radio" name="PersonalPhoneUse" value="Yes"> Yes
<input type="radio" name="PersonalPhoneUse" value="No" checked> No</p>
</blockquote>
<p><b>Do other employee's in your Department use a cell phone for Department
business that is paid for with personal out of pocket funds?</b></p>
<blockquote>
<p style="margin-top: 1; margin-bottom: 1">
<input type="radio" name="EmployeePersonalPhoneUse" value="Yes"> Yes
<input type="radio" name="EmployeePersonalPhoneUse" value="No" checked> No
<input type="radio" name="EmployeePersonalPhoneUse" value="Unsure"> Unsure</p>
<p style="margin-top: 1; margin-bottom: 1"><b>If Yes, how many employees:</b>
<select name="EmployeePersonalPhoneUseQuantity" size="1">
<option selected>0</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
</select></p>
</blockquote>
<!--msthemeseparator--><p align="center"><img src="../_themes/copy-of-blends/blesepa.gif" width="600" height="10"></p>
<p align="justify"><b>The following questions pertain to cell phones provided
by the Town of Needham paid for with Town of Needham funds.</b></p>
<p align="justify"><b>Does your Department use </b><strong>Town provided cell
phones?:</strong></p>
<p align="justify" style="margin-top: 1; margin-bottom: 1"><strong>
<input type="radio" name="TownProvidedPhone" value="Yes"> </strong>Yes
<input type="radio" name="TownProvidedPhone" value="No" checked> No</p>
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<p align="justify" style="margin-top: 1; margin-bottom: 1">If you answered
'No' to this question please proceed to the bottom of this page and select
'Submit'.</p>
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<p align="justify" style="margin-top: 1; margin-bottom: 1"> </p>
<p style="margin-top: 1; margin-bottom: 1"><strong>Cell Phone Provider for
Town provided cell phone(s) in your Department:</strong></p>
<dl>
<dd><input type="radio" name="TownPhoneProvider" value="Nextel">NEXTEL<input type="radio" name="TownPhoneProvider" value="Verizon">Verizon
<input type="radio" name="TownPhoneProvider" value="Sprint">Sprint
<input type="radio" name="TownPhoneProvider" value="ATT">ATT
<input type="radio" name="TownPhoneProvider" value="Cingular">Cingular
<input type="radio" name="TownPhoneProvider" value="T-Mobile">T-Mobile
<input type="radio" name="TownPhoneProvider" value="Other">Other
<input type="radio" name="TownPhoneProvider" value="None" checked>None</dd>
<dt><b> If Other enter Provider name
for Town cell phone(s):</b></dt>
<dd><textarea name="OtherProvider" rows="1" cols="42"></textarea></dd>
</dl>
<p><b>Quantity of Town provided cell phones in your Department:</b></p>
<blockquote>
<p><select name="Quantity" size="1">
<option selected>0</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
</select></p>
</blockquote>
<p><strong>Description of Plan(s) for Town provided cell phone(s) in your
Department:</strong></p>
<p><textarea name="Description" rows="5" cols="42"></textarea></p>
<p><b>Annual Price of Plan(s) for Town </b><strong>provided </strong><b>cell
phone(s) in your Department:</b></p>
<p><textarea name="AnnualPrice" rows="5" cols="42"></textarea></p>
<p><strong>Contract(s) End Date(s) </strong><b>for Town </b><strong>provided </strong><b>
cell phone(s)</b><strong> in your Department:</strong></p>
<p><textarea name="ContractEndDate" rows="5" cols="42"></textarea></p>
<p> </p>
<p align="center">
<input type="submit" value="Submit" name="Submit" style="font-size: 18pt; background-color: #FF0000">
<input type="reset" value="Clear" name="Clear" style="font-size: 18pt; background-color: #99FF99"></p>
</form>
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<p align="left" style="margin-top: 1; margin-bottom: 1"><font size="1">Created
by Roger MacDonald</font></p>
<p align="left" style="margin-top: 1; margin-bottom: 1"><font size="1">Town of
Needham</font></p>
<p align="left" style="margin-top: 1; margin-bottom: 1"><font size="1">
<!--webbot bot="Timestamp" S-Type="EDITED" S-Format="%m/%d/%Y" startspan -->01/08/2007<!--webbot bot="Timestamp" i-checksum="12620" endspan --></font></p>
<p align="center"> </p>
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