Form Page

This form helps us learn a little bit about you so our process can be made easier. You will be sent joining instructions once we receive your info. and you key to paradise is almost on its way.

Please identify and describe yourself:

First name

Last name

Middle initial

Date of birth

Sex Male Female

Height

Weight

Hair color

Eye color

Choose your free gift:

Select the countries you would visit:

France       India        Mexico       Bhutan     
New Zealand  Wales        Pakistan     Congo      
Finland

How many people have you killed in the last 5 years?

Would you like to die ?

Yes No

Enter the time of the last slaute :

-- hh:mm:ss am/pm

How would you rate your opinion of the devil ?

bad poor average fair good

How would you rate your opinion of god?

bad poor average fair good

Tie Breaker: Why do you deserve to enter paradise ?

First name
Last name
Middle initial
Date of birth
Sex	Male Female
Height
Weight
Hair color
Eye color

Form Page

Copyright to the first to register.. Last revised: August 27, 1999

Copyright to the first to register..
Last revised: August 27, 1999