I Wanna Know About
YOU
!
If You take this survey, I'll e-mail you some
COOL SITES!
Also, anything with a
*
is NOT required to answer.
1)What's your first name?
*2)What's your last name?
3)What's your e-mail address?
*4)What's your nickname? (NO Special letters)
5)What's your age?
Sex?
Male
Female
Other
Alien
Often
Yes Please!
*6)What's your address?
*7)What city do you live in?
8)What state are you from?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticuit
D.C.
Delaware
Florida
Georgia
Hawaii
Idaho
Illinios
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missourri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
9)Do you have AOL?
Yes
No
10)Do you have a webpage?
Yes
No
if so. . . . type it below.
If so. . . . what's it about.
11)(Last one) What are your interests?
Sports
Computers
Video Games
Collectable Card Games
Books
Other
If you picked other. . . tell me about it.
(Reset Form)
THANK YOU!!!
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