<XMP><body><!--'"</title></head>--> <script type="text/javascript"> //OwnerIQ var __oiq_pct = 50; if( __oiq_pct>=100 || Math.floor(Math.random()*100/(100-__oiq_pct)) > 0 ) { var _oiqq = _oiqq || []; _oiqq.push(['oiq_addPageBrand','Lycos']); _oiqq.push(['oiq_addPageCat','Internet > Websites']); _oiqq.push(['oiq_addPageLifecycle','Intend']); _oiqq.push(['oiq_doTag']); (function() { var oiq = document.createElement('script'); oiq.type = 'text/javascript'; oiq.async = true; oiq.src = document.location.protocol + '//px.owneriq.net/stas/s/lycosn.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(oiq, s); })(); } /////// Google Analytics var _gaq = _gaq || []; _gaq.push(['_setAccount', 'UA-21402695-21']); _gaq.push(['_setDomainName', 'angelfire.com']); _gaq.push(['_setCustomVar', 1, 'member_name', 'ia/Geoff', 3]); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); ////// Lycos Initialization ///////////////////// var lycos_ad = Array(); var lycos_search_query = ""; var lycos_onload_timer; var cm_role = "live"; var cm_host = "angelfire.lycos.com"; var cm_taxid = "/memberembedded"; var angelfire_member_name = "ia/Geoff"; var angelfire_member_page = "ia/Geoff/form.html"; var angelfire_ratings_hash = "1713281889:961e99a533662dffb9aef4ed8fba1c92"; var lycos_ad_category = {"dmoz":"business\/food_and_related_products","ontarget":"&CAT=family%20and%20lifestyles&L2CAT=food%20and%20wine","find_what":"paris"}; var lycos_ad_remote_addr = "209.202.244.9"; var lycos_ad_www_server = "www.angelfire.lycos.com"; var edit_site_url = "www.angelfire.lycos.com/landing/landing.tmpl?utm_source=house&utm_medium=landingpage&utm_campaign=toolbarlink"; </script> <script type="text/javascript" src="https://scripts.lycos.com/catman/init.js"></script> <script type='text/javascript'> var googletag = googletag || {}; googletag.cmd = googletag.cmd || []; (function() { var gads = document.createElement('script'); gads.async = true; gads.type = 'text/javascript'; var useSSL = 'https:' == document.location.protocol; gads.src = (useSSL ? 'https:' : 'http:') + '//www.googletagservices.com/tag/js/gpt.js'; var node = document.getElementsByTagName('script')[0]; node.parentNode.insertBefore(gads, node); })(); </script> <script type='text/javascript'> googletag.cmd.push(function() { googletag.defineSlot('/95963596/ANG_300x250_dfp', [300, 250], 'div-gpt-ad-1450207484070-0').addService(googletag.pubads()); googletag.enableServices(); }); </script> <script type='text/javascript'> googletag.cmd.push(function() { googletag.defineSlot('/95963596/ANG_above_728x90_dfp', [728, 90], 'div-gpt-ad-1450207484070-1').addService(googletag.pubads()); googletag.enableServices(); }); </script> <script type='text/javascript'> googletag.cmd.push(function() { googletag.defineSlot('/95963596/ANG_below_728X90_dfp', [728, 90], 'div-gpt-ad-1450207484070-2').addService(googletag.pubads()); googletag.enableServices(); }); </script> <script type="text/javascript"> (function(isV) { if (!isV) { return; } //this.lycos_search_query = lycos_get_search_referrer(); var adMgr = new AdManager(); var lycos_prod_set = adMgr.chooseProductSet(); var slots = ["leaderboard", "leaderboard2", "toolbar_image", "toolbar_text", "smallbox", "top_promo", "footer2","slider"]; var adCat = this.lycos_ad_category; adMgr.setForcedParam('page', (adCat && adCat.dmoz) ? adCat.dmoz : 'member'); if (this.lycos_search_query) { adMgr.setForcedParam("keyword", this.lycos_search_query); } else if (adCat && adCat.find_what) { adMgr.setForcedParam('keyword', adCat.find_what); } for (var s in slots) { var slot = slots[s]; if (adMgr.isSlotAvailable(slot)) { this.lycos_ad[slot] = adMgr.getSlot(slot); } } adMgr.renderHeader(); adMgr.renderFooter(); }((function() { var w = 0, h = 0, minimumThreshold = 300; if (top == self) { return true; } if (typeof(window.innerWidth) == 'number' ) { w = window.innerWidth; h = window.innerHeight; } else if (document.documentElement && (document.documentElement.clientWidth || document.documentElement.clientHeight)) { w = document.documentElement.clientWidth; h = document.documentElement.clientHeight; } else if (document.body && (document.body.clientWidth || document.body.clientHeight)) { w = document.body.clientWidth; h = document.body.clientHeight; } return ((w > minimumThreshold) && (h > minimumThreshold)); }()))); window.onload = function() { var f = document.getElementById("lycosFooterAd"); var b = document.getElementsByTagName("body")[0]; b.appendChild(f); f.style.display = "block"; document.getElementById('lycosFooterAdiFrame').src = '/adm/ad/footerAd.iframe.html'; // Slider Injection (function() { var e = document.createElement('iframe'); e.style.border = '0'; e.style.margin = 0; e.style.display = 'block'; e.style.cssFloat = 'right'; e.style.height = '254px'; e.style.overflow = 'hidden'; e.style.padding = 0; e.style.width = '300px'; })(); // Bottom Ad Injection ( function() { var b = document.getElementsByTagName("body")[0]; var iif = document.createElement('iframe'); iif.style.border = '0'; iif.style.margin = 0; iif.style.display = 'block'; iif.style.cssFloat = 'right'; iif.style.height = '254px'; iif.style.overflow = 'hidden'; iif.style.padding = 0; iif.style.width = '300px'; iif.src = '/adm/ad/injectAd.iframe.html'; var cdiv = document.createElement('div'); cdiv.style = "width:300px;margin:10px auto;"; cdiv.appendChild( iif ); if( b ) { b.insertBefore(cdiv, b.lastChild); } })(); } </script> <style> #body .adCenterClass { margin:0 auto; display:block !important; overflow:hidden; width:100%; } #body .adCenterClass #ad_container { display:block !important; float:left; width:728px; } @media (min-width: 768px) { <!-- For 300px or less ads ONLY --> #body .adCenterClass #ad_container { width: calc(100% - 372px); } } @media (min-width: 1110px) { <!-- For 728px or less ads --> #body .adCenterClass #ad_container { width: calc(100% - 372px); } } </style> <div style="background:#abe6f6; border-bottom:1px solid #507a87; position:relative; z-index:9999999"> <div class="adCenterClass"> <a href="https://www.angelfire.lycos.com/" title="Angelfire.com: build your free website today!" style="display:block; float:left; width:186px; border:0"> <img src="/adm/ad/angelfire-freeAd.jpg" alt="Site hosted by Angelfire.com: Build your free website today!" style="display:block; border:0" /> </a> <div id="ad_container"> <script type="text/javascript">document.write(lycos_ad['leaderboard']);</script> </div> </div> </div> <!-- ///////////////////////////////////// --> <script type="text/javascript">document.write(lycos_ad['slider']);</script> <div id="lycosFooterAd" style="background:#abe6f6; border-top:1px solid #507a87; clear:both; display:none; position:relative; z-index:9999999"> <div class="adCenterClass" style="display:block!important; overflow:hidden; width:936px;"> <div id="aflinksholder" style="float:left; width:186px;"> <a href="https://www.angelfire.lycos.com/" title="Angelfire.com: build your free website today!" style="display:block; border:0"> <img src="/adm/ad/angelfire-freeAd2.jpg" alt="Site hosted by Angelfire.com: Build your free website today!" style="display:block; border:0" /> </a> </div> <iframe id="lycosFooterAdiFrame" style="border:0; display:block; float:left; height:96px; overflow:hidden; padding:0; width:750px"></iframe> </div> </div> <!--- UNDERDOGMEDIA EDGE_lycos.com JavaScript ADCODE START---> <script data-cfasync="false" language="javascript" async src="//udmserve.net/udm/img.fetch?sid=17754;tid=1;dt=6;"></script> <!--- UNDERDOGMEDIA EDGE_lycos.com JavaScript ADCODE END---> </xmp>

All Fields Required, a form not completely filled out will be discarded (city not required for rural residents)

Full Legal Name

Sex
If you selected Other, please explain

Race
Name or describe your race(s) as simply as possible


Current Marital Status


Sexual Orientation
Heterosexual
Homosexual
Uncertain
Bisexual
I would prefer not to say


Highest Level of Education Achieved


Occupation Field


Month of Birth

Year of Birth

Location of Birth


Religion
Please define your religious path as simply, but accurately as possible


Parents' Religion
Please define your parents' religious beliefs as simply, but accurately as possible


How many years have you been a Pagan?


How do you usually practice your religion
Alone
In a group
Alone AND in a group
Non-practicing


Who knows that you are Pagan (select all that apply)
None of my friends
Some friends
Most friends
All friends

None of my family
Some family
Most family
All family

No strangers
Some strangers
Most strangers
All of the general public in my community

My employer


Have you ever been discriminated against because you were Pagan?
Yes
No

If you answered "Yes" please briefly describe how somebody discriminated against you


Location
County:

City:


Zipcode

Are you registered to vote in Iowa?
Yes
No


Are you registered to vote in another state?
Yes
No

Did you vote in the last presidential election?
Yes
No

Do you vote in municipal elections (during non-presidential years)?
Yes
No

Political Party
If you don't know the official name of your party, check out this list of political parties (it will open in a new window).


How many years have you lived in Iowa?


Approximately how many more years do you expect to live in Iowa?
If you intend to spend the rest of your life here, please say so.


Are you currently in a romantic relationship with another Pagan
Yes
No


Are you currently in a romantic relationship with somebody who is NOT a Pagan
Yes
No


How many children under age 18 do you have?

Please list their ages.

How many children under age 18 do you have who consider themselves Pagan?

Please list their ages.



Any Additional Comments

Scroll through and make certain that you answered each question. A form without questions answered will be discarded.


Please only press Submit once.

Cancel
<XMP></body></xmp>