SURVEY

Hello, this is a survey page for submitting feedback about my page. All info entered will be sent to me, not posted as in the guestbook.

Please tell me your name: (Do not hit return)

How old are you?

Under 18 years old
Between 19 and 24 years old
Between 25 and 34 years old
Between 35 and 44 years old
More than 45 years old
Don't want to say

How often do you visit my page?

Every Day
Once per week
Once per month
Once per year
This is my first visit

Please provide your comments about my page

1
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