Leave one's marks

I wonder if I could have any further information about you.

NAME: AGE: ------ UNDER 10 10 - 14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 OVER 70

COUNTRY:

MAIL:

OCCUPATION:

SEX: MALE FEMALE

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How many times do you visit to Yossy's Home Page?

First time 2- 5 times 6 - 9 times Over 10 times

Will you please watch Yossy's HomePage over and send me your comments, if possible?

Thank you.

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