First Name Last Name (Last Name Is Optional )

E-Mail Address REQUIRED!!

Net Newbie - I need help ! I am an expert - Would love to help a newbie !

Mutual Health Support - I am dealing with

• Arthritis
• Aids
• Crohn's Disease or Colitis
• Diabetes
• Lupus
• Cancer
• Heart Disease
• Asthma
• Multiple Scleroses
• (A Health Problem Not Listed)
• I am the caretaker for someone suffering from

Religion: I would like to share religous Fellowship with someone.

• I am a Christian
• I am Jewish
• I am a Muslim
• I am

and would love to corresponde with

• a Christian
• a Jew
• a Muslim
• a

Cooking:

• Help - I am just learning to cook & need help!
• I know my way around the kitchen. Let me help a beginner!
• I am a good cook & would love to exchange recipes with other good cooks!

Sports:

• Take me out to the Ball Game - I love Baseball
• I am a Fan of Pro Football
• I love the slamming & Jamming Of Pro Basketball
• I love the cool action of NHL Hockey
• I love College Football
• I can't wait for March - I love College Basketball
• Track & Field is my favorite
• I am a hunter / fisherman
• All Others -

Soap Opera - I am a fan of:

• Days Of Our Lives
• As The World Turns
• The Young & The Restless
• Guiding Light
• General Hospital
• The Bold & The Beautiful
• Melrose Place
• Mines Not Listed! How about

All Others - Hey! My interest is not included. How about

Please tell me a little bit about you self:

Thank you for you for your interest in our program. We will respond to you as soon as possible!