Name:
Email:
Age:
City:
State:
Social
Security Number:
What
is your annual income?
What
percentage of your annual income do you spend on drugs?
How
often do you have sex a week?
With
whom do you have sex?
NOTE: P lease
provide full names and phone numbers, if possible.
What
are your prefered sexual positions (check all that apply):
Regular
Hump
On-top
What
is your mom's name?
Where
does your mom live?
Does
your mom's home have a central security system ?
Yes
No
Do you have
any of the following medical conditions:
Diarhea
Bad breath
Loose balls
Club feet
Bald
Lost limbs
Mental illness
Just plain dumb
Would
you like to make a tax-deductible donation to the Larry Armstrong
Home for Wayward Boys and Girls Fund (a unprofitable organization
that helps people)?
Yes
No
May
we use all the information you have entered above, plus any information
we can extract from your computer through any means available
to us and Microsoft Corp., to sell to our clients, customers,
friends, associates, third-parties, third-world countries, and
anyone else who will buy it from us?
Yes
No
Your
comments:
Note:
We really don't care what nonsense you have to say and probably
won't respond, unless we want to screw with you.