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A: Background
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Full Name
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What is your gender?
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Male
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What Year Were You Born?
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What is your email address?
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What City and State do you currently reside in?
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How did you hear about PrizeSquare.com?
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Flyer or Newsletter
Banner Advertisement
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What is your current relationship status?
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Single
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What is your current housing situation?
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B: Professional
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What is the highest level of education you completed?
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Elementary School
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High School Diploma
Technical School Certificate
Junior College Degree
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Are you currently employed?
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C: Personal
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How many hours per day do you spend online?
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2-3 hours
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6+ hours
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What do you use the internet for?
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Information Gathering
Academic Research
Shopping
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News
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E-mail
Job Hunting
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Stock Market
Other:
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Please be as specific as possible10 referrals to our website earns you entry into a top secret PrizeSquare drawing!