This likert scale survey template shows three ways to present the same rating question on paper, so you can pick the format that fits your project. It is a compact one-page example for anyone learning how likert scales look in print, from course instructors and HR teams to customer experience and academic researchers. The template has three grid questions and fits comfortably on a single printed page.
What this survey measures
Each grid asks respondents to react to the same four statements about a product, which makes the three scale styles easy to compare side by side. The first grid uses a classic five-point agree to disagree scale from Strongly Agree to Strongly Disagree. The second grid replaces words with sad, neutral, and smiling faces for a quick emoji-style rating. The third grid offers a numeric one to ten scale for finer gradations of agreement.
How to use it on paper
Print the survey and hand it out at the end of a class, training session, event, or product demo where people already have the item in front of them. Ask respondents to use a blue or black pen and mark one box per row. Collect the completed sheets in a single stack, then scan or photograph them and upload to PaperSurvey. The optical mark recognition reads every checked box automatically and turns the marks into structured results you can chart and export.
Customize this template
Most people keep one scale style and remove the other two, then swap the four statement rows for their own. You can add your logo, rewrite the scale labels, extend the numeric range, or add open response questions for comments. The layout reflows automatically as you edit, so spacing and page breaks stay clean.
Preview the PDF above, or use this template to start collecting responses today.