Test Form 5

This form provides a lot of information that is parsed, decoded, then returned with each item on a separate line.

Fill Out This Part

Click on the "Submit" button when you have filled out all of the data.

Enter your name:
Enter your e-mail address:

I like to eat (check all that apply): Pizza Hamburgers Chocolate Granola

I am: Under 20 20 - 29 30 - 45 46 - 65 Over 65

Pick your favorite company:

Enter a comment:

Jon Wiederspan
Last edited: November 9, 1994