<?xml version="1.0" encoding="iso-8859-1"?>
<!DOCTYPE wml PUBLIC "-//WAPFORUM//DTD WML 1.3//EN" "http://www.wapforum.org/DTD/wml13.dtd" >
<wml>
<card title="Crime Survey" newcontext="true">
<p>
<img src="http://sentido.co.za/EMAIL/senditolarge.jpg" alt="Sentido - Mobile Application Providers"/><br/>
<b>Crime Survey</b><br/>
Please answer the following questions:<br/><br/>
1. Were you a victim of crime in the past 12 months?<br/>
<select name="q1">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>

2. Do you think crime will be under control by 2010?<br/>
<select name="q2">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>

3. Do you think crime stifles economic growth in SA?<br/>
<select name="q3">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>

4. Do you think crime levels have decreased over the last 10 years?<br/>
<select name="q4">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>

5. Do you think affirmative action in the SAPS is to blame for perceived crime levels?<br/>
<select name="q5">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>

6. Do you think the Death Penalty should be brought back?<br/>
<select name="q6">
<option value=""> -- </option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select><br/><br/>
Your race?<br/>
<select name="race">
<option value="Black">Black</option>
<option value="Coloured">Coloured</option>
<option value="Indian/Asian">Indian/Asian</option>
<option value="White">White</option>
</select><br/>
<anchor>
<go method="post" href="survey.php">
<postfield name="q1" value="$(q1)"/>
<postfield name="q2" value="$(q2)"/>
<postfield name="q3" value="$(q3)"/>
<postfield name="q4" value="$(q4)"/>
<postfield name="q5" value="$(q5)"/>
<postfield name="q6" value="$(q6)"/>
<postfield name="race" value="$(race)"/>
</go>
Submit
</anchor>
<br/>
<anchor>
<go href="http://www.tellza.mobi"/>
Back
</anchor>
<br/><br/>
<anchor>
<go href="report.wml"/>
Report a crime
</anchor><br/>
<anchor>
<go href="results.php"/>
View results
</anchor>
</p>
</card>
</wml>