Response-O-Matic Form

 

Join The Monk Obsessed Fan Club!

Just fill out this registration form and click on the Register button when ready to send. All personal information will remain confidential and handled professionally.

 


Handle or nickname:


Name:


E-mail address:


Birthday:

, 19

Address:


City:


State:


Country:

Gender: Male Female

Would you like to be on the board of directors? [If you choose 'yes' we will e-mail you the lated positons open and other important information you need to know.]

How would you rate the monk obsessed site? Excellent
Good
Fair
Poor
Bad

Are you a member of the yahoo group? [If you are not a member it does not mean you cannot join. Everyone is invited to join.]

If you have any questions, comments, and/or suggestions for/about the Counteragents fan club please put them here.

 

we suggest using your message board handle but it isn't required.
[optional except for year]
[optional]