My Web Form Page

Please Enter The Following Information

Y0ur FiRst NaMe i$:
aND the school y0u g0 t0 i$:
aNd you stAY in the cIty OF:

The color I like most is :
Turquoise
Purple
Dark Green
Daisy Yellow
Navy Blue
Click ALL That Apply:
I am very active
I don't share my business with anyone
I have big dreams to accomplish
Must have some sort of technology with me at all times
I have never got "F" in school
Enjoy being involved in school activities
What is your Favorite Food?

Favorite Mall?