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Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: rtsolorio@msn.com.

Thank you for visiting my sign in page. Please take a few minutes to fill out my survey form. Thank you! :) All answers are kept confidential.

Name:

Homepage_url:

Email address:

Occupation:

Location:

Age:

Are you male or female?

Male
Female
Neuter

Do you go to school?

No
College
High School
Elementary
Junior High School

Do you have any pets?

A dog
A cat
Both
Neither
Other

Do you work?

Yes
No
EEK! Don't say that word!
I work all day for what?!?

Did you read my disclaimer? :)

Yes...Add me to the tally!
No
What's a disclaimer?

Did you enjoy my homepage?

Yes
No
Maybe so
Awesome!!
Can I wake up now?

Do you have a homepage?

Yes
No
I will soon!

Do you IRC?

Yes
No
What is IRC?
I'm not sure...Should I?
IRC addict

How did you hear about my homepage?

IRC
A friend told me
A little bird told me...
Steve, you told me moron!!!
Other

Do you think I am curious?

Yes
No
Don't you have a life?
Everyone is curious
Curiosity killed the cat!

Is this annoying?

Yes
No
Why are you so annoying?!?!
I love the attention!

How many licks does it take to get to the Tootsie Roll center of a Tootsie Pop?

One
Two
Three

Do you care if I email you?

Yes
No

Suggestions,comments,etc:

Back to my Homepage

Thank you for taking the time to fill out my survey. All responses will be confidential. However, if I enjoy your comments and/or suggestions I may email you back. :) Bye Bye now!

rtsolorio@msn.com

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