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More about you!!

Here I have a form. I decided to build this as I'd like to find out more about you :-) The visitors to my site. I'd like to get to know you better!

It is totally up to you whether you fill this out or not. I will keep the information private. But I would really like to hear from you.

If you do decide to go ahead and complete the form, please do not fill in anything you don't want. ALL QUESTIONS ARE OPTIONAL!

And if you have anything you want to ask me, just go ahead and do so. I will try really hard to get back to you.

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About You

What is your name?

What is your email address?

How old are you?     

Where do you live?

Do you have a homepage? yes   no

If you do, what is your URL?

What is you site about?

Have you been to this site before? yes    no, this is my first time here

Where did you hear about this site?

If you have been here before, how often?

What do you think of the site?

Do you self harm? yes  no

Do you suffer from a mental illness? yes  no

If you do, what do you suffer from?


How long have you had access to the internet for?

How often do you access the internet? 

What are your favourite web sites?

Do you have an instant messenger?          yahoo messenger   

 AOL instant messenger        ICQ        other    I don't have one


yahoo ID:


AOL screen name:



Do you use chat rooms or message boards?

Do you   work    go to school    go to college    go to university

What do you work as/study?   

do you have a girlfriend/boyfriend/husband/wife? yes    no

What is your favourite film?   

What kind of music do you like?   

What is your favourite food?       

What is your favourite colour?       

Do you drive?    yes    no

What do you do when you can't sleep?

what do you do in your free time?

what do you do for a laugh?

what are you thinking right now?


Please feel free to add comments of your own.