What's your name?
Where are you from?
Your e-mail address?
How much you study at home per day?
2 to 3 hours.
3 to 4 hours.
4 to 5 hours.
5 to 6 hours.
How much do you play per day?
0 to 0.5 hours.
0.5 to 1 hours.
1 to 2 hours.
2 to 3 hours.
Check the fruit you eat, uncheck the ones you don't:
Bananas
Oranges
Apples
Grapes
Peaches
Select your favorite passtime:
Your Comments Please?
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