Please take a minute to fill out this form
so I can better serve the you at my Web Site.
Name:
Please tell me what you think
about my Web site:
What I liked best: What I liked least:
Where are you from?
RACE: What is your age?
Check all that apply:
e-mail address: Web site address:
Other Comments:
BLACK Under 18 25 35 45 55 65 Over
65
Student Instructor Possible
employer friend family I
don't know you male female Too
$hort fan Lost Web surfer Web
publisher Republican Democrat Libertarian Communist other