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Name:

Name of Web Site:

URL of Web Site:

How many hours are you online a month?
2 or below 3 - 10 11 - 20 21 or above
Are You On At Least 3 Times A Week?
Yes No
How Would You DescribeYour Web Design Experience?
Expert Know some HTML Know no HTML but have a page Beginner or have no page
Why does your page qualify to be on my page, and any questions about My Site: