SharePoint Survey

Hi Everyone,
I'd like to create a survey with check boxes option for the type of answer of the question.  I'd like to add a text box under each question.  I want to do it like how it's showing below:

Any idea how I can do that?  Thanks in advance for your help.
Who is Participating?
There is no way to specify your own verbage. ...unless you dig into the code of how sharepoint presents the options -I don't know how to do that. The best you can do is click the radio box to allow 'Fill-in' choices: with a Yes and then take what they give you. "Specify your own value:"

Another idea would be to add a question with "Multiple lines of text"
 looks like this to users:
you can do it with standard Survey
amarelvAuthor Commented:
Hi George -  Thank you so much for the quick reply.  Could you please provide me instructions where I can checkbox AND  text box  for the type of answer of the question.
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Use a multiple choice question ,
Check the option to allow user to enter own value.
amarelvAuthor Commented:
Hi George - Thank you for working with me on this request.

Could you please let me know if I could change the wording of the "Specify your own value" to "If other/product/ life event".

That should be your last choice in the choice list

Go to List Settings :

under the Question / Column "What brought ... ? "   that would be the last choice , Change it to any text you want.
amarelvAuthor Commented:
Hi George,
Based on your suggestion,  I made "If other/product/ life event - be specific" the last choice but wanted users to fill out a text box when selecting that option so I checked off "Yes" in the Allow "Fill-in' choices.
List Settings
I'm still getting the "Specify your own value:"  
 QuestionCould you please tell me where I could have "If other/product/life event - be specific" the last choice and have a text box below it.  I'd like to get rid of the "Specify your own value" but still want user to fill out a text box.
that was the answer proposed.

but i also wanted to see if the user is comfortable with java scripts.

you can edit the form or the site master page to have the text replaced.

i don't like doing that myself but can do it if needed.

maintenance and migration will be a chall
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