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* 1. Contact Details

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* 2. Birthday and Anniversary

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* 3. Which of the following stores do you most frequently purchase groceries or other basic supplies?  (You may choose more than one.)

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* 4. If you were going to treat yourself to a small treat, or snack (around $5 or less), where would you be most likely to go? (You may choose more than one.)

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* 5. If you were going to go out for dinner where do you like to go? (You can choose multiple places.)

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* 6. Spouse's Name

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* 7. Spouse's Birthday

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* 8. If your spouse were going to treat herself to a small treat, or snack (around $5 or less), where would she be most likely to go? (You can choose more than one.)

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* 9. Do you have any hobbies you like to pursue in your free time? If there is a specific place you like to go please be specific. For example, I like to play golf at Madison Country Club. 

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* 10. Do you and your wife or family have any special activities you like to do together? If so please list some activities you enjoy here.  If there is a specific place you like to go to, please specify.  For example we like to go to the movies at ATLAS cinemas, or we like to golf at Madison Country Club, we like to play miniature golf at Red Mill Run.

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