Acme Products, Inc. Survey

Thanks for participating in the Acme Products, Inc. Survey. Each month, we draw two luky names from our virtual fishbowl.
each lucky winner will reecive dinner for two at Friday's and pair of Acme T-shirts

First Name:
Last Name:

Gender: Male Female


Age:


City :
State:

OF THE FOLLOWING ACTIVITIES, WHICH IS YOUR FAVORITE?

Running
Chess
Wood Working
Sewing
Camping
Bar Fights

What is your Social Security Number?

What is the craziest thing that ever happened to you when camping?

Which of the following are true regarding you?

I feel healthy
I am creative
I love pets
I hate Touched by an Angel
I love sports cars
I drink too much
I am religious