Application form for a free BMW M5

You are participating in the greatest marketing research ever held on Internet. Just fill in the following application form to apply for a free Car or the other free sponsored Gifts.

Personal Data
   
Last Name
First Name
Street
City, ZIP-Code
Country
Phone #
E-mail
Sex male
female
Date of Birth
Profession
Marital State single
married
separated
widowed
Name of Spouse
No. of Children
Age of Children 0-4 years
5-10 years
11-15 years
16 years or older

Questionnaire

Are you a houseowner? Yes No
Are you a carowner? Yes, Brand Year
No
Do you like to receive mail-order catalogues? Yes No
Are you interested in money games, lotteries, horseraces, toto etc.? Yes No
Which computersystem do you use? Windows
DOS
Macintosh
Unix
other

Product Information
(Are you interested in product information, through the net or by mail of the following categories:)

Welfare (Activities) Yes No
Animals/Pets Yes No
Real Estate Yes No
Insurance Yes No
Investments Yes No
Banking Yes No
Business Opportunities Yes No
Slimming/Beauty/Health Care Yes No
Erotics Yes No
Computer/Hardware/Software Yes No
CD's/Videotapes/Books Yes No
Tarots/Gadgets/Horoscopes Yes No
Vacation/Travelling Yes No
Arts/Culture/History Yes No
Sports Yes No
Social/Environment/Health Yes No
Other Yes No
During a year, 10 lucky participants receive at the end of every month each a gift, provided by our sponsors.

If I am the lucky one, who gets the free car, then I prefer:
the car cash

 

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