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Questionnaire

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Birthdate

Marital Status

If you are married, what is your spouse's name and date of your wedding anniversary?

Children (Names & Ages):

Pets:

T-Shirt/Sweatshirt Size:

Allergis or Diet Restrictions:

Sit Down Restaurant(s):

Fast Food Restaurant(s):

Coffee Shop(s):

Tea(s):

Soda(s):

Sparkling/Flavored Water(s):

Store(s):

Online Store(s):

Salty Snack(s):

Sweet Snack(s):

Candy and/or Chocolate:

Gum and/or Mints:

Color(s):

Hobbies: