<form action='http://www.kwiz.biz/simplesurveys/do-survey.php' method='post' target='_new'><table border=1 bordercolor=#efefef cellspacing=0><tr><td valign=top align=right>Name:</td><td align=left><b>Jamie</b><input type='hidden' name='question1' value='Name%3A'><input type='hidden' name='type1' value='1'></td></tr><tr><td valign=top align=right>Birthdate:</td><td align=left><b>June 24</b><input type='hidden' name='question2' value='Birthdate%3A'><input type='hidden' name='type2' value='1'></td></tr><tr><td valign=top align=right>Birthplace:</td><td align=left><b>Sin city</b><input type='hidden' name='question3' value='Birthplace%3A'><input type='hidden' name='type3' value='1'></td></tr><tr><td valign=top align=right>Current Location:</td><td align=left><b>On My a**</b><input type='hidden' name='question4' value='Current+Location%3A'><input type='hidden' name='type4' value='1'></td></tr><tr><td valign=top align=right>Eye Color:</td><td align=left><b>Green</b><input type='hidden' name='question5' value='Eye+Color%3A'><input type='hidden' name='type5' value='1'></td></tr><tr><td valign=top align=right>Hair Color:</td><td align=left><b>Burgundy</b><input type='hidden' name='question6' value='Hair+Color%3A'><input type='hidden' name='type6' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>Height:</i></b><input type='hidden' name='question7' value='Height%3A'><input type='hidden' name='type7' value=''></td></tr><tr><td valign=top align=right>Piercings:</td><td align=left><b>My eyebrow was done...three in my left two in my right.</b><input type='hidden' name='question9' value='Piercings%3A'><input type='hidden' name='type9' value='1'></td></tr><tr><td valign=top align=right>Tatoos:</td><td align=left><b>None</b><input type='hidden' name='question10' value='Tatoos%3A'><input type='hidden' name='type10' value='1'></td></tr><tr><td valign=top align=right>Boyfriend/Girlfriend:</td><td align=left><b>Boyfriend</b><input type='hidden' name='question11' value='Boyfriend%2FGirlfriend%3A'><input type='hidden' name='type11' value='1'></td></tr><tr><td valign=top align=right>Overused Phraze:</td><td align=left><b>What the hell</b><input type='hidden' name='question12' value='Overused+Phraze%3A'><input type='hidden' name='type12' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>FAVORITES</i></b><input type='hidden' name='question13' value='FAVORITES'><input type='hidden' name='type13' value='2'></td></tr><tr><td valign=top align=right>Food:</td><td align=left><b>Taco Salad</b><input type='hidden' name='question14' value='Food%3A'><input type='hidden' name='type14' value='1'></td></tr><tr><td valign=top align=right>Candy:</td><td align=left><b>Jolly ranchers</b><input type='hidden' name='question15' value='Candy%3A'><input type='hidden' name='type15' value='1'></td></tr><tr><td valign=top align=right>Number:</td><td align=left><b>5</b><input type='hidden' name='question16' value='Number%3A'><input type='hidden' name='type16' value='1'></td></tr><tr><td valign=top align=right>Color:</td><td align=left><b>Green</b><input type='hidden' name='question17' value='Color%3A'><input type='hidden' name='type17' value='1'></td></tr><tr><td valign=top align=right>Animal:</td><td align=left><b>All</b><input type='hidden' name='question18' value='Animal%3A'><input type='hidden' name='type18' value='1'></td></tr><tr><td valign=top align=right>Drink:</td><td align=left><b>Rootbeer</b><input type='hidden' name='question19' value='Drink%3A'><input type='hidden' name='type19' value='1'></td></tr><tr><td valign=top align=right>Alcohol Drink:</td><td align=left><b>Mikes hard lemonade, orange juice and rum, strait vodka</b><input type='hidden' name='question20' value='Alcohol+Drink%3A'><input type='hidden' name='type20' value='1'></td></tr><tr><td valign=top align=right>Bagel:</td><td align=left><b>With cream cheese</b><input type='hidden' name='question21' value='Bagel%3A'><input type='hidden' name='type21' value='1'></td></tr><tr><td valign=top align=right>Letter:</td><td align=left><b>L-oser</b><input type='hidden' name='question22' value='Letter%3A'><input type='hidden' name='type22' value='1'></td></tr><tr><td valign=top align=right>Body Part on Opposite sex:</td><td align=left><b>Were do you think....</b><input type='hidden' name='question23' value='Body+Part+on+Opposite+sex%3A'><input type='hidden' name='type23' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>This or That</i></b><input type='hidden' name='question24' value='This+or+That'><input type='hidden' name='type24' value='2'></td></tr><tr><td valign=top align=right>Pepsi or Coke:</td><td align=left><b>Sprite</b><input type='hidden' name='question25' value='Pepsi+or+Coke%3A'><input type='hidden' name='type25' value='1'></td></tr><tr><td valign=top align=right>McDonalds or BurgerKing:</td><td align=left><b>Roberto's</b><input type='hidden' name='question26' value='McDonalds+or+BurgerKing%3A'><input type='hidden' name='type26' value='1'></td></tr><tr><td valign=top align=right>Strawberry or Watermelon:</td><td align=left><b>Lemon</b><input type='hidden' name='question27' value='Strawberry+or+Watermelon%3A'><input type='hidden' name='type27' value='1'></td></tr><tr><td valign=top align=right>Hot tea or Ice tea:</td><td align=left><b>Ice Tea</b><input type='hidden' name='question28' value='Hot+tea+or+Ice+tea%3A'><input type='hidden' name='type28' value='1'></td></tr><tr><td valign=top align=right>Chocolate or Vanilla</td><td align=left><b>Vanilla</b><input type='hidden' name='question29' value='Chocolate+or+Vanilla'><input type='hidden' name='type29' value='1'></td></tr><tr><td valign=top align=right>Hot Chocolate or Coffee:</td><td align=left><b>Coffee</b><input type='hidden' name='question30' value='Hot+Chocolate+or+Coffee%3A'><input type='hidden' name='type30' value='1'></td></tr><tr><td valign=top align=right>Kiss or Hug:</td><td align=left><b>Both</b><input type='hidden' name='question31' value='Kiss+or+Hug%3A'><input type='hidden' name='type31' value='1'></td></tr><tr><td valign=top align=right>Dog or Cat:</td><td align=left><b>Both</b><input type='hidden' name='question32' value='Dog+or+Cat%3A'><input type='hidden' name='type32' value='1'></td></tr><tr><td valign=top align=right>Rap or Punk:</td><td align=left><b>Depends....</b><input type='hidden' name='question33' value='Rap+or+Punk%3A'><input type='hidden' name='type33' value='1'></td></tr><tr><td valign=top align=right>Summer or Winter:</td><td align=left><b>Winter</b><input type='hidden' name='question34' value='Summer+or+Winter%3A'><input type='hidden' name='type34' value='1'></td></tr><tr><td valign=top align=right>Scary Movies or Funny Movies:</td><td align=left><b>All in one</b><input type='hidden' name='question35' value='Scary+Movies+or+Funny+Movies%3A'><input type='hidden' name='type35' value='1'></td></tr><tr><td valign=top align=right>Love or Money:</td><td align=left><b>Love....AND money</b><input type='hidden' name='question36' value='Love+or+Money%3A'><input type='hidden' name='type36' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>YOUR...</i></b><input type='hidden' name='question37' value='YOUR...'><input type='hidden' name='type37' value='2'></td></tr><tr><td valign=top align=right>Bedtime:</td><td align=left><b>whenever</b><input type='hidden' name='question38' value='Bedtime%3A'><input type='hidden' name='type38' value='1'></td></tr><tr><td valign=top align=right>Most Missed Memory:</td><td align=left><b>My Dad</b><input type='hidden' name='question39' value='Most+Missed+Memory%3A'><input type='hidden' name='type39' value='1'></td></tr><tr><td valign=top align=right>Best phyiscal feature:</td><td align=left><b>you decide</b><input type='hidden' name='question40' value='Best+phyiscal+feature%3A'><input type='hidden' name='type40' value='1'></td></tr><tr><td valign=top align=right>First Thought Waking Up:</td><td align=left><b>5 more min...</b><input type='hidden' name='question41' value='First+Thought+Waking+Up%3A'><input type='hidden' name='type41' value='1'></td></tr><tr><td valign=top align=right>Goal for this year:</td><td align=left><b>To go back to school..</b><input type='hidden' name='question42' value='Goal+for+this+year%3A'><input type='hidden' name='type42' value='1'></td></tr><tr><td valign=top align=right>Best Friends:</td><td align=left><b>Stephanie..Alanna..</b><input type='hidden' name='question43' value='Best+Friends%3A'><input type='hidden' name='type43' value='1'></td></tr><tr><td valign=top align=right>Weakness:</td><td align=left><b>Being kissed on on my neck...</b><input type='hidden' name='question44' value='Weakness%3A'><input type='hidden' name='type44' value='1'></td></tr><tr><td valign=top align=right>Fears:</td><td align=left><b>none since i faced mine..(thankx olajide)</b><input type='hidden' name='question45' value='Fears%3A'><input type='hidden' name='type45' value='1'></td></tr><tr><td valign=top align=right>Heritage:</td><td align=left><b>Dutch,german,french,italian,cherokee indian,mexican...</b><input type='hidden' name='question46' value='Heritage%3A'><input type='hidden' name='type46' value='1'></td></tr><tr><td valign=top align=right>Longest relationship:</td><td align=left><b>a year..</b><input type='hidden' name='question47' value='Longest+relationship%3A'><input type='hidden' name='type47' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>HAVE YOU...</i></b><input type='hidden' name='question48' value='HAVE+YOU...'><input type='hidden' name='type48' value='2'></td></tr><tr><td valign=top align=right>Ever Drank:</td><td align=left><b>yes im an alchy sowwie....</b><input type='hidden' name='question49' value='Ever+Drank%3A'><input type='hidden' name='type49' value='1'></td></tr><tr><td valign=top align=right>Ever Smoked:</td><td align=left><b>yes..quit..</b><input type='hidden' name='question50' value='Ever+Smoked%3A'><input type='hidden' name='type50' value='1'></td></tr><tr><td valign=top align=right>Pot:</td><td align=left><b>yes..still do ocasionally</b><input type='hidden' name='question51' value='Pot%3A'><input type='hidden' name='type51' value='1'></td></tr><tr><td valign=top align=right>Ever been Drunk:</td><td align=left><b>ys</b><input type='hidden' name='question52' value='Ever+been+Drunk%3A'><input type='hidden' name='type52' value='1'></td></tr><tr><td valign=top align=right>Ever been beaten up:</td><td align=left><b>no</b><input type='hidden' name='question53' value='Ever+been+beaten+up%3A'><input type='hidden' name='type53' value='1'></td></tr><tr><td valign=top align=right>Ever beaten someone up:</td><td align=left><b>hell yea</b><input type='hidden' name='question54' value='Ever+beaten+someone+up%3A'><input type='hidden' name='type54' value='1'></td></tr><tr><td valign=top align=right>Ever Shoplifted:</td><td align=left><b>yes...(ashamed)</b><input type='hidden' name='question55' value='Ever+Shoplifted%3A'><input type='hidden' name='type55' value='1'></td></tr><tr><td valign=top align=right>Ever Skinny Dipped:</td><td align=left><b>yes</b><input type='hidden' name='question56' value='Ever+Skinny+Dipped%3A'><input type='hidden' name='type56' value='1'></td></tr><tr><td valign=top align=right>Ever Kissed Opposite sex:</td><td align=left><b>once..(was drunk)</b><input type='hidden' name='question57' value='Ever+Kissed+Opposite+sex%3A'><input type='hidden' name='type57' value='1'></td></tr><tr><td valign=top align=right>Been Dumped Lately:</td><td align=left><b>No..and yes</b><input type='hidden' name='question58' value='Been+Dumped+Lately%3A'><input type='hidden' name='type58' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>IN A GUY/GIRL</i></b><input type='hidden' name='question59' value='IN+A+GUY%2FGIRL'><input type='hidden' name='type59' value='2'></td></tr><tr><td valign=top align=right>Favorite Eye Color:</td><td align=left><b>green</b><input type='hidden' name='question60' value='Favorite+Eye+Color%3A'><input type='hidden' name='type60' value='1'></td></tr><tr><td valign=top align=right>Favorite Hair Color:</td><td align=left><b>any</b><input type='hidden' name='question61' value='Favorite+Hair+Color%3A'><input type='hidden' name='type61' value='1'></td></tr><tr><td valign=top align=right>Short or Long:</td><td align=left><b>short not too short</b><input type='hidden' name='question62' value='Short+or+Long%3A'><input type='hidden' name='type62' value='1'></td></tr><tr><td valign=top align=right>Height:</td><td align=left><b>above 5'9''</b><input type='hidden' name='question63' value='Height%3A'><input type='hidden' name='type63' value='1'></td></tr><tr><td valign=top align=right>Style:</td><td align=left><b>themselves</b><input type='hidden' name='question64' value='Style%3A'><input type='hidden' name='type64' value='1'></td></tr><tr><td valign=top align=right>Looks or Personality:</td><td align=left><b>personality</b><input type='hidden' name='question65' value='Looks+or+Personality%3A'><input type='hidden' name='type65' value='1'></td></tr><tr><td valign=top align=right>Hot or Cute</td><td align=left><b>both</b><input type='hidden' name='question66' value='Hot+or+Cute'><input type='hidden' name='type66' value='1'></td></tr><tr><td valign=top align=right>Drugs and Alcohol:</td><td align=left><b>doesnt matter</b><input type='hidden' name='question68' value='Drugs+and+Alcohol%3A'><input type='hidden' name='type68' value='1'></td></tr><tr><td valign=top align=right>Muscular or Really Skinny:</td><td align=left><b>not real skinny</b><input type='hidden' name='question69' value='Muscular+or+Really+Skinny%3A'><input type='hidden' name='type69' value='1'></td></tr><tr><td valign=top align=center colspan=2><b><i>RANDOMS</i></b><input type='hidden' name='question70' value='RANDOMS'><input type='hidden' name='type70' value='2'></td></tr><tr><td valign=top align=right>Number of Regrets in the Past:</td><td align=left><b>89532548745.........</b><input type='hidden' name='question71' value='Number+of+Regrets+in+the+Past%3A'><input type='hidden' name='type71' value='1'></td></tr><tr><td valign=top align=right>What country do you want to Visit:</td><td align=left><b>England</b><input type='hidden' name='question72' value='What+country+do+you+want+to+Visit%3A'><input type='hidden' name='type72' value='1'></td></tr><tr><td valign=top align=right>How do you want to Die:</td><td align=left><b>suicide..</b><input type='hidden' name='question73' value='How+do+you+want+to+Die%3A'><input type='hidden' name='type73' value='1'></td></tr><tr><td valign=top align=right>Been to the Mall Lately:</td><td align=left><b>no</b><input type='hidden' name='question74' value='Been+to+the+Mall+Lately%3A'><input type='hidden' name='type74' value='1'></td></tr><tr><td valign=top align=right>Do you like Thunderstorms:</td><td align=left><b>yes</b><input type='hidden' name='question75' value='Do+you+like+Thunderstorms%3A'><input type='hidden' name='type75' value='1'></td></tr><tr><td valign=top align=right>Get along with your Parents:</td><td align=left><b>dont live with my mom....</b><input type='hidden' name='question76' value='Get+along+with+your+Parents%3A'><input type='hidden' name='type76' value='1'></td></tr><tr><td valign=top align=right>Health Freak:</td><td align=left><b>i dk</b><input type='hidden' name='question77' value='Health+Freak%3A'><input type='hidden' name='type77' value='1'></td></tr><tr><td valign=top align=right>Do you think your Attractive:</td><td align=left><b>no</b><input type='hidden' name='question78' value='Do+you+think+your+Attractive%3A'><input type='hidden' name='type78' value='1'></td></tr><tr><td valign=top align=right>Believe in Yourself:</td><td align=left><b>no</b><input type='hidden' name='question79' value='Believe+in+Yourself%3A'><input type='hidden' name='type79' value='1'></td></tr><tr><td valign=top align=right>Want to go to College:</td><td align=left><b>yes</b><input type='hidden' name='question80' value='Want+to+go+to+College%3A'><input type='hidden' name='type80' value='1'></td></tr><tr><td valign=top align=right>Do you Smoke:</td><td align=left><b>no</b><input type='hidden' name='question81' value='Do+you+Smoke%3A'><input type='hidden' name='type81' value='1'></td></tr><tr><td valign=top align=right>Do you Drink:</td><td align=left><b>yes</b><input type='hidden' name='question82' value='Do+you+Drink%3A'><input type='hidden' name='type82' value='1'></td></tr><tr><td valign=top align=right>Shower Daily:</td><td align=left><b>yes</b><input type='hidden' name='question83' value='Shower+Daily%3A'><input type='hidden' name='type83' value='1'></td></tr><tr><td valign=top align=right>Been in Love:</td><td align=left><b>yes</b><input type='hidden' name='question84' value='Been+in+Love%3A'><input type='hidden' name='type84' value='1'></td></tr><tr><td valign=top align=right>Do you Sing:</td><td align=left><b>yes</b><input type='hidden' name='question85' value='Do+you+Sing%3A'><input type='hidden' name='type85' value='1'></td></tr><tr><td valign=top align=right>Want to get Married:</td><td align=left><b>yes</b><input type='hidden' name='question86' value='Want+to+get+Married%3A'><input type='hidden' name='type86' value='1'></td></tr><tr><td valign=top align=right>Do you want Children:</td><td align=left><b>2</b><input type='hidden' name='question87' value='Do+you+want+Children%3A'><input type='hidden' name='type87' value='1'></td></tr><tr><td valign=top align=right>Have your future kids names planned out:</td><td align=left><b>boy: Kristopher Nathen girl: Kaylen may</b><input type='hidden' name='question88' value='Have+your+future+kids+names+planned+out%3A'><input type='hidden' name='type88' value='1'></td></tr><tr><td valign=top align=right>Age you wanna lose your Virginity:</td><td align=left><b>i did at 15</b><input type='hidden' name='question89' value='Age+you+wanna+lose+your+Virginity%3A'><input type='hidden' name='type89' value='1'></td></tr><tr><td valign=top align=right>Hate anyone:</td><td align=left><b>yes..</b><input type='hidden' name='question90' value='Hate+anyone%3A'><input type='hidden' name='type90' value='1'></td></tr><tr><td colspan=2 align=center><input type='submit' value='Take This Survey'><BR><a href='http://www.kwiz.biz/simplesurveys/create-survey.php'>CREATE YOUR OWN!</a> - or - <a href='http://www.kwiz.biz/simplesurveys/paid-surveys.php'>GET PAID TO TAKE SURVEYS!</a></td></tr></form></table>
JamieRawxx · Mon Nov 14, 2005 @ 01:17am · 0 Comments |