This likert scale survey template shows several ways to present a 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 rating grids, a seven-point slider and a recommend score, and fits on a single printed page.
What this survey measures
Each grid asks respondents to react to the same three statements about a product, which makes the scale styles easy to compare side by side. The first grid uses a classic five-point scale from Strongly disagree to Strongly agree. 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. A seven-point satisfaction slider and a zero to ten likelihood-to-recommend question round out the page.
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 circle 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 three 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.