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When my quick survey of 30 unsubscription processes didn't turn up any surveys with a closed-end question, I went looking for them. 

From the Office Depot survey:

We value your opinion!

We would appreciate it if you took a moment to tell us why you unsubscribed:

• I don't remember subscribing to receive emails from Office Depot
• The offers and promotions are not as good as I expected them to be
• The content was not relevant to me
• I have found another retailer to shop for these items
• I receive too many emails from Office Depot
• Other

From the Microsoft Unsubscribe survey:

• I already receive too much e-mail
• I am not interested in receiving promotional e-mail from Microsoft
• Information in e-mail is not relevant to my job/company
• I have changed my e-mail address/job/location
• I don't recall signing up to receive e-mail from Microsoft
• E-mail address is no longer active
• Other (please describe your reason in the "Comments" box)

From the Borders unsubscribe survey:

Thank you. You have been unsubscribed from our email list.

We at Borders strive to deliver informative and valuable emails to our customers.

To help us continue to improve, we would appreciate it if you took a moment
to tell us why you unsubscribed (select as many as apply):

• I receive too many emails in general.
• I like receiving Borders emails, just not as often.
• I am having difficulty receiving or viewing Borders emails.
• I do not remember subscribing to receive emails from Borders.
• I do not find the content of current Borders emails useful.
• I am not interested in Borders at this time.
• Other:

I like the Microsoft use of a general comments box, so that you can get any open feedback the respondent wants to provide - the added color can be helpful.  I like that the Office Depot survey tracks for lost business ("I have found another retailer to shop for these items"). And I like the Borders approach of asking the survey question after the unsubscribe form: it flowed seamlessly, was clearly optional (you've already been unsubscribed by this point) and kept the unsubscribe form simple. 

Which choices you should provide in your own unsubscription survey depends in part on what decisions you are going to make from these results.  I hope these three examples provide you with a good start.