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Please fill out some information about your significant other so that we can get a better idea of something that you may want to give her.  None of this information is stored anywhere, so don't worry about your privacy.

 All Fields In Red Are Required 
Name:  (This is to give the report a personal touch.)

About Her

Age:
15-19
20-24
25-29
30-34
35-39
40-49
50-59
60-64
65+
Children:
0-1
2-3
4-5
6+
Children's Ages:
n/a
0-3
4-11
12-17
18+

Occupation:
Homemaker
Sales
Food Service
Lawyer
Doctor
Other Professional
Self-Employed
Other
Work Hours
Full-Time
Part-Time
Swing
Graveyard
On The Road

Hobbies/Interests  (Check all that apply)
Architecture
Art
Beauty
Cars
Cooking
Crafts
Fashion
Gardening
Internet
Kids
Movies
Music
Reading
Religion
Sewing
Sex
Skydiving
Software
Tools
Travel
Welding
Woodworking
Writing
Other

Other Information

Length Of Time Together:
< 6 months
6-12 months
1-5 years
5-10 years
10+ years
Reason For The Gift:
Birthday
Christmas
Anniversary
I'm a jerk (apology)
Just because
   
 


 

Soccer
Photos
Send Dave
Into Space
Stop the
Front Range
Toll Road!
Fight!
 
     Copyright 2002-2004 - David Charles Reed Last Updated: 06 January 2005