Your name:

Your e-mail address:

How did you find our site? Word of mouth Clicked on link Clicked on banner Bookmark Yahoo alta Vista Excite HotBot InfoSeek Other Search engine

How often do you visit this site? Every_day Every week Every_month It's my first time here

Overall rating for this site? Excellent | Good | OK | Bad

Would you like a $10 webpage? yes no

Your address will be   www. --- Select a Domain Below --- A-VIP.com AudioPhile.com BioGate.com Biosys.net BitSmart.com ComPorts.com Cryogen.com CyberJunkie.com DeathsDoor.com DigiCron.com DittosRush.com EarthCorp.com GalaxyCorp.com POBoxes.com Psynet.net RadioLink.net Tande.com The18thHole.com TheGym.net TheOffice.net ThePentagon.com TheWaterCooler.com TeenWorld.POBoxes.com /your_acount_name

What do you want your acount name to be. (eg. surgewse)

Would you like an e-mail address to go with your site. yes no

Would you like an e-mail form? yes no

If yes, which one? DEFAULT 1 DEFAULT 2 CUSTOM DON'T WANT ONE

Do you want a hit counter? yes no

Do you want a guestbook? yes no

If yes, which one? DEFAULT CUSTOM DON'T WANT ONE

Would you like a clock? yes no

Would you like a date stamp? yes no

Would you like a quote on a buisness site? yes no

Are you a nonprofit organization? yes no

If yes what is the organizations name?

Comments?

� 1998 Superior Web Design Will Pitt [email protected]