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<HTML>

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<META NAME="description" CONTENT="Motorcycle Poker Run">
<META NAME="Keywords"    CONTENT="Motorcycle Poker Run">


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<TITLE>Give Us Your Opinions</TITLE></head>
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                                                        <td bgcolor="#66ff66" nowrap>&nbsp; 


<font face='Comic Sans MS' size='2' color='#000000'>

Give Us Your Opinions

</font>


 &nbsp;</td>
                                                        <td width="50%" valign="top" align="left"><img src="widgets/gen_36.1.gif"></td>
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<form name="questionary" action="http://1.sitebuilderserver.com/servlet/psoft.customform.CustomForm" method="post">
<input type="hidden" name="domain" value="http://louisianamelonrun.com/">
<input type="hidden" name="title" value="Give Us Your Opinions">

<input type="hidden" name="name" value="=GghoWXsbVRbLl=b">


<input type="hidden" name="order" value="17 18 19 20 21 22 23 24 d25 ">
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<TABLE border="0" cellpadding="5" cellspacing="0" width="95%">
<tr>
	<td colspan=2>&nbsp;</td>
</tr>


<input type="hidden" name="name_17" value="Have you participated in the Louisiana Melon Run before?">
<tr>	
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<font face='Comic Sans MS' size='2' color='#000000'>

Have you participated in the Louisiana Melon Run before?

</font>


<font color="red" size="-1">*</font></td>
	<td>


 <input type="radio" name="field_17" value="Yes">


<font face='Comic Sans MS' size='2' color='#000000'>

Yes

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<font face='Comic Sans MS' size='2' color='#000000'>

No

</font>


</td>
</tr> 

<input type="hidden" name="name_18" value="If so, tell us about your experience with the Melon Run.">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

If so, tell us about your experience with the Melon Run.

</font>


</td>
	<td>


<textarea name="field_18" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_19" value="Do you have any suggestions or complaints regarding the ride or how the Melon Run was organized?">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

Do you have any suggestions or complaints regarding the ride or how the Melon Run was organized?

</font>


<font color="red" size="-1">*</font></td>
	<td>


 <input type="radio" name="field_19" value="Yes">


<font face='Comic Sans MS' size='2' color='#000000'>

Yes

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 <input type="radio" name="field_19" value="No">


<font face='Comic Sans MS' size='2' color='#000000'>

No

</font>


</td>
</tr> 

<input type="hidden" name="name_20" value="If so, please tell us your suggestions / complaints.">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

If so, please tell us your suggestions / complaints.

</font>


</td>
	<td>


<textarea name="field_20" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_21" value="Please tell us if you have any ideas for additional routes that the Melon Run can use next year.">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

Please tell us if you have any ideas for additional routes that the Melon Run can use next year.

</font>


</td>
	<td>


<textarea name="field_21" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_22" value="Are you already included in our mailing list?">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

Are you already included in our mailing list?

</font>


<font color="red" size="-1">*</font></td>
	<td>


 <input type="radio" name="field_22" value="Yes">


<font face='Comic Sans MS' size='2' color='#000000'>

Yes

</font>


 <input type="radio" name="field_22" value="No">


<font face='Comic Sans MS' size='2' color='#000000'>

No

</font>


</td>
</tr> 

<input type="hidden" name="name_23" value="If not, please supply your email and mailing address, and you will be added to our mailing list.">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

If not, please supply your email and mailing address, and you will be added to our mailing list.

</font>


</td>
	<td>


<textarea name="field_23" rows="5" cols="30"></textarea>


</td>
</tr> 

<input type="hidden" name="name_24" value="Please provide us with your name.">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

Please provide us with your name.

</font>


</td>
	<td>


<input type="text" name="field_24" size="35">


</td>
</tr> 

<input type="hidden" name="name_25" value="Date:">
<tr>	
	<td>


<font face='Comic Sans MS' size='2' color='#000000'>

Date:

</font>


<font color="red" size="-1">*</font></td>
	<td>


<select name="field_m_25" size="1">
<option>Jan
<option>Feb
<option>Mar
<option>Apr
<option>May
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<option>1<option>2<option>3<option>4<option>5<option>6<option>7<option>8<option>9<option>10<option>11<option>12<option>13<option>14<option>15<option>16<option>17<option>18<option>19<option>20<option>21<option>22<option>23<option>24<option>25<option>26<option>27<option>28<option>29<option>30<option>31
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                                <img src="widgets/gen_13.1.gif" border="0" width="164" height="5"></td>
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                                <a href="survey.html" onMouseOver="document.images['img13'].src='widgets/gen_60.1.gif'" onMouseOut="document.images['img13'].src='widgets/gen_61.1.gif'"><img src="widgets/gen_61.1.gif" alt="Survey" name="img13" border="0"></a>
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                <td align="center" colspan="3" valign="top" bgcolor="#66ff66">
                        

<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">Welcome</A>|</nobr>

<nobr>|<a href="about.html">About</A>|</nobr>

<nobr>|<a href="registration.html">Registration</A>|</nobr>

<nobr>|<a href="tshirt.html">T-Shirt</A>|</nobr>

<nobr>|<a href="sponsors.html">Sponsors</A>|</nobr>

<nobr>|<a href="pictures.html.0.html">Pictures</A>|</nobr>

<nobr>|<a href="links.html">Links</A>|</nobr>

<nobr>|Survey|</nobr>

<nobr>|<a href="contact.html">Contact Us</A>|</nobr>
</center>
</font>

<BR>
                        
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<br>
<font face="helvetica,verdana, arial" size="1">Copyright 2009 Louisiana Melon Run, Inc.</font>

</td></tr></table></center>
</td>
        </tr>
                
</table>


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