CHAT NAME____________________________________________
SPOUSE NAME__________________________________________
ADDRESS______________________________________________
PHONE NO.____________________________________________
E-MAIL ADDRESS_______________________________________
VOCATION_____________________________________________
INTERESTS____________________________________________
WHY OR HOW DID YOU PICK YOUR CHAT NAME?______________
_____________________________________________________
NO. OF PEOPLE IN YOUR PARTY?_________________________
AMOUNT ENCLOSED______________________________________
A PRIZE WILL BE GIVEN THE THE WINNER OF THE MOST UNIQUE CHAT NAME TAG, MAKE ONE, AND GOOD LUCK IN THE CONTEST.
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