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Address:

Phone:

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Survey...

My favorite talk show host is...

What's your least favorite color?

How long have you been attending AC3?

In what year did you graduate High school?

What pet’s do you own (mark all that apply)
cat     dog     rodent     bird     reptile     farm animal     other

Favorite candy or snack food?

What is your favorite sport to watch?

Ever been to a country besides U.S. or Canada?yes   no
If yes, which ones?

What food do you dislike the most?

What’s your favorite beverage?

I’ve watched the following reality TV programs (mark all that apply):
dancing with stars  amazing race   biggest loser   american idol   survivor
                                                    none of the above

My favorite presidential candidate so far is...

If I was an animal, I’d be a....

Have you ever taken dance lessons of any kind?  Yes   No

Do you wear contact lenses?   Yes   No

The best present I ever got was...

I am a (select one)
Morning Person     Night Owl          24/7 Grump     Always Ready

Have you been to VisionCast before? Yes   No

The ice cream I choose most is (select only one):
Vanilla     Chocolate     Mint Chip     Cookie Dough     Sherbert

I prefer to be: Indoors   Outdoors   Other

If I won a dream vacation, I’d prefer (select one):
Australia     Alps     Alaska     Austria     Algeria

Do you like your middle name? Yes   No

Do you have children? Yes   No

My favorite children’s story is...

The last movie I saw in the theater was

Do you own a laptop computer? Yes   No

Do you like green veggies? Yes   No

Have you ever been on TV? Yes   No

Favorite Villain

Favorite musician

My feelings about the downgrading of Pluto are:
sad    mad    indignant    didn't know Disney had done that

My favorite Olympic event is...

Famous person you’d like to meet

Who would play you in the movie of your life

In my family, I am the (select one):
oldest     youngest     middle     only     forgotten     favorite

I like to have my picture taken Yes   No

I am a good sleeper Yes   No

One thing people probably don’t know about me

My favorite thing to do with my free time is

Favorite book of the bible

Word most often used to describe me 

Babies love me  yes  no

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