Can you guys help me to do this survey?

https://docs.google.com/spreadsheet/viewform?pli=1&formkey=dGQ1dWNYZVJSQUVuczdDTy1vbWJIcVE6MQ#gid=0

not sure why the link is not working. have to copy and paste to see the link :(

It's google document.. safe to go to the link..

Thanks for helping.. really appreciated.