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* 1. Your Email Address

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* 2. In what country do you currently reside?

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* 4. Are you currently a high school student?

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* 5. Are you currently a college / university student?

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* 6. Are you 21 or over?

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* 7. Are you interested in hearing about Truth or Fail coming to a place near you?

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* 8. Are you interested in helping bring Truth or Fail to a place near you?

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* 9. Do you currently work at a business that is interested in Truth or Fail?

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* 10. Do you currently work at a school that is interested in Truth or Fail?

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* 11. Do you currently work somewhere else that is interested in Truth or Fail?

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* 12. Do you have anything you'd like to let us know?

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