The Questionnaire

This Questionnaire will take about 20 minutes to complete, and very EASY to do. It may take longer if you dwell upon the memories that will come up as you think about your answers. In any event, it should be fun. Feel free to take a look at the Questionnaire below, but if you have not paid the processing fee, then you should probably return to the HOME page and take care of that. Then check your email, and look for the confirmation of your payment, and make note of the Order Number.

* Indicates required field

On the confirmation Email that you received after paying the processing fee for the FOREVER PICTURE, you will find your order number.

Your Order Number: *

Information about You

Regardless of who's answers are being entered on the questionnaire, please enter your information below. Unless otherwise requested, your FOREVER PICTURE will be mailed to you at the address you provide.

Name: *

First

Last

Email: *

Phone Number: (optional but suggested) *

Mailing Address: *

City: *

State: *

Zipcode: *

The person answering the questions

In the space provided, enter the name of the person whose answers will be entered on the questionnaire. If that's you, then enter your name. If you plan to answer the questions on behalf of someone else, enter his or her name.

Name of the person answering questions: *

If you ordered a FOREVER PICTURE that features a photo of the person who is answering the question, you may upload it using the link below.

To upload a photo image: *

Max file size: 20MB

Special instructions about the photo: *

The Questions begin here:

Q1. Place of Birth? *

Q2. Life long lucky number? *

Q3. Nickname while growing up? *

Q4. Pet's name while growing up? *

Q5. Favorite Super Power? *

Q6. Choice of another country to live? *

Q7. Name of best friend growing up? *

Q8. How would you describe your Faith? *

Q9. Favorite HOBBY or pastime? *

Q10. Favorite Expression (ie., neat, cool) *

Q11. Favorite spectator game or sport? *

Q12. Favorite participation game or sport? *

Q13. Favorite musical group or artist? *

Q14. Favorite AUTHOR? *

Q15. Favorite MOVIE or PLAY? *

Q16. Favorite SONG of all time? *

Q17. Favorite SOURCE for news? *

Q18. Favorite LOCAL restaurant? *

Q19. Favorite OUT-OF-TOWN restaurant? *

Q20. Favorite ENTREE to order? *

Q21. Favorite APPETIZER to order? *

Q22. Favorite DESSERT? *

Q23. Favorite home cooked meal? *

Q24. Favorite ICE CREAM Flavor? *

Q25. Favorite VEGETABLE? *

Q26. Favorite FRUIT? *

Q27. Favorite CANDY? *

Q28. Favorite SALAD DRESSING? *

Q29. Favorite DONUT or PASTRY? *

Q30. Favorite US PRESIDENT? *

Q31. DREAM job? *

Q32. Most ENJOYABLE job? *

Q33. MOST DIFFICULT job? *

Q34. Very FIRST job? *

Q35. Most famous person ever met? *

Q36. Famous person like to meet? *

Q37. Highest level of education? *

Q38. Most important VIRTUE (honesty, etc.) *

Q39. MILITARY service? *

Q40. Top Bucket List item? *

If you click the SUBMIT button but nothing seems to happen, then there might still be some "required" fields that were left blank. Please scroll up and check to make sure.

Are you ready to submit these answers? *

Yes No

Submit