Lazy People Company®

Survey Form

First of all, we would like to thank you for visiting our website. Since you are here we would be glad if you would kindly tell me more about yourself and if possible, we will keep you updated about our Lazy People Company®. ( Refer to Warning ! )
 

Your Particulars

1 . Title : First Name : Last Name :

2 . Initial :

3 . Age : Years

4 . Type of Organization :

5 . Name of Organization :

6 . Metropolitan / City / Town :

7 . Country :

8 . Course of Studies ( If Any ) :

9 . How do you rate our Home Page ?

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  • Real Bad
  • I Wanna Go to the Toilet

10. Do you want us to keep in touch with you ? Yes No

11. E-Mail Address :

12. Anything you wanna say ?

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Copyright© 1993 - 1997, Lazy People Company®, Bandar Baru Bangi, Selangor, MY.
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Last Updated : 14 January 1997