To: 
Subject: 
Name: 
 
Age: 
0-15
16-25
25-50
Not Telling.
I have run out of options!! 
 
Email: 
 
Homepage: 
 
Name of homepage: 
 
How did you find me? 
Just Surfed On In!
Looked under a Rock.
Internet Link Exchange
Im not even sure im here
Spilled Pepsi on keyboard and now it won't work.
I just flew in and my arms are tired
Found URL written on the bathroom wall
Magic
I'm not here, it's all in your imagination.
Where am I?
Lost and can't find my way back!
Clicked on the wrong thing!
Just Lucky, I Guess!
Looking for my Free Drink! 
 
Where are you from? 
Another Planet
My Living Room
England
Australia
United States
Canada
 
What Kind of Drink do you Prefer? 
Coors Lite
Coors Lite
Coors Lite
Coors Lite
Coors Lite
Coors Lite
 

Comments:(or "What's on your mind today?") 
 
 





You only need to press SUBMIT one time...Thanks! 
 
Remember.....If you are using Microsoft Internet Explorer you will have to email this to me....only Netscape 2.0 and higher will read this form....... 
 
Now carefully open the CD Rom and walla..............Thanks!

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