diff --git a/app/templates/orbit_bootstrap/modules/survey/index.html.erb b/app/templates/orbit_bootstrap/modules/survey/index.html.erb
new file mode 100644
index 0000000..b9100f3
--- /dev/null
+++ b/app/templates/orbit_bootstrap/modules/survey/index.html.erb
@@ -0,0 +1,20 @@
+<table class="table table-hover table-striped survey-index">
+  <caption><h3>{{page-title}}</h3></caption>
+  <thead>
+    <tr>
+      <th class="col-md-6">{{th_title}}</th>
+      <th class="col-md-3">{{th_time_range}}</th>
+      <th class="col-md-1">{{th_write}}</th>
+      <th class="col-md-1">{{th_result}}</th>
+    </tr>
+  </thead>
+  <tbody data-level="0" data-list="surveys">
+    <tr>
+      <td>{{title}}</td>
+      <td>{{time_range}}</td>
+      <td>{{write}}</td>
+      <td>{{result}}</td>
+    </tr>
+  </tbody>
+</table>
+{{pagination_goes_here}}
\ No newline at end of file