Site hosted by Angelfire.com: Build your free website today!

TAP YOUR BRAIN

Registration Form

That's the spirit! Here we'll take your name and address and do some, um...very trustworthy things with them! Even though half of it bears absolutely no relation to being a TAP YOUR BRAIN member, we need it anyway! And we won't sell your info to anyone. Well, we might give it away to telemarketers, but we won't sell it! GUARANTEED!

Title:
Mr. Ms. Mrs. Miss. Dr.

Name:
First: Last:

Phone #:

E-mail address:

Address:

Educational Level:

(The only reason we put this here is to verify how much indoctrination you have received. The less, the better.)

Favorite Colors:

Brain Cells (approximate):

Have you...
Been raised by fundamentalists?
Played Rugby?
Voted for Pat Buchanan?
Used duct tape as toilet paper?
Been born in Indiana? (IMPORTANT)

If you answered yes to ANY of these, you are at risk for brain closure! Too many knocks will seal it up good!

Of course, all of this is just info! It by no means bars you from the club, but it will make assimilation somewhat more, um...interesting. So Press the button below and YOU are a member of Tap Your Brain!

Home Page	About This Site		Author	Other Designers
Links	Downloads	Projects	Rhetoric	Psychology	Sign up!