If you are doing a survey, it is good to keep it anonymous. Also, you are relatively unknown, and always, before I give anyone information I want to know:
1. Who is this person? (and why would I want to help you?)
2. Who do they work for? ("reputed firm" does not cut it, you need to be specific)
3. How are they going to use this information?

You might want to check out something like www.surveymonkey.com to get an idea how to set things up.

Good luck