1. what is your gender?
2. female
   male
3. what is your age?
4. 25 - 35
   35 - 45
   45 - 55
   55 - 65
   over 65
5. what state do you live in?
6. what is your approximate income?
7. $15,000 - $20,000/yr
   $20,000 - $40,000/yr
   $40,000 - $60,000/yr
   $60,000 - $80,000/yr
   over $80,000/yr
8. leave a comment (optional)
9. who should we donate $5 to?
10. Hurricane Relief via the American Red Cross www.american.redcross.org
    Humane Society of the U.S. helping to rescue animals in disaster areas www.hsus.org
    Carbon Neutral Fund helping to fight global warming www.carbonfund.org

 

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