I want to win a MELVIN T-Shirt, a free sack of gourmet coffee and those damned subway tokens. Please pass this data along to your marketing department, so that they may more efficiently exploit the commercial potential of the World Wide Web. I understand that failing to answer these questions truthfully will result in chronic ocular hemorraging.


E-Mail Address*:

Daytime Phone Number*:

*For purposes of awarding prizes only. Trust us.

State or nation of residence:


Male Female

Yearly Income:
less than $15,000
$15,000 to $24,999
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
I want to invest

Do you:

Have a car?
Yes No

Have a credit card?
Yes No

Have a house?
Yes No

Purchase CDs regularly?
Yes No

Attend rock concerts regularly?
Yes No

Go to the movies frequently?
Yes No

Work for a college or university?
Yes No

Work for the government?
Yes No

Are You:

A student?
Yes No

Connecting to the WWW through a commercial on-line service?
Yes No

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