Please take a few minutes to complete my dating survey

Please take a few minutes to complete my dating survey.

  What's your name?
  
  Are you single?
  
    Yes    
      No (if no, stop
      right here)
  
  Where would you like to take me on our first
  date?
  Breakfast                   
  Lunch                   
  Dinner                       
  Movie                       
  Dinner
  & Movie        
  Romantic
  Getaway
  Caribbean
  Cruise           
  Pizza
  & Wings         
  Other
  Do you like sports?
  Yes           
  No
  If yes, what sports?
  Football                      
    Baseball                
  Hockey
  Basketball                    
   Soccer                   
  Wrestling
  Arm
  Wrestling               
   Thumb
  Wrestling         
  Midget
  Tossing
  Beer
  Pong                    
    Other  
   
  Do you consider yourself to be...
  ...a
  nice guy?           
  ...kind?           
  ...considerate?
  ...caring?                  
  ...out of
  your mind for taking this survey?

Anything else you'd like me to know about you?


  
    
  
  Tell me how to get in touch with you:
If you leave your email address, I'll
  try to reply in a timely manner.
Once you click 'submit' it will open your
Outlook email program to mail the results to me. You won't get a virus, so
please don't freak when you see the warning from Microsoft. 
 
Thanks for taking the
time to complete my survey. I hope you enjoyed it.
Shelly
  
    
      
        
          
          
        
        
          E-mail
          
        
        
          Phone
          
        
        
          
          
        
      
    
  
  
  


Shelly's dating survey.

Revised: 
.

Shelly's dating survey. Revised: .

Shelly's dating survey.
Revised: .