Natural Hair Color:
[ ] Brown - $100
[ ] Blonde - $50
[ ] Black - $15
[ ] Bald - $5
[x] Other - $75   ---- mixture of blonde and some others

Total:  $75

Eye Color:
[ ] Brown - $50
[ ] Green - $75
[x] Blue - $150
[ ] Hazel - $100
[ ] Other - $15

Total so far:  $225

Height:
[ ] Over 7′ - $200
[ ] 6′8″ to 7′ - $175
[ ] 6′0″ to 6′7″ - $150
[x] 5′5″ to 5′11″ - $75
[ ] 5′4″ to 5′10″ - $85
[ ] Under 5′4 - $0

Total so far:  $300

Age:
[ ] 50 to 56 - $175
[ ] 46 to 50 - $150
[ ] 41 to 45 - $125
[ ] 31 to 40 - $100
[ ] 26 to 30 - $75
[ ] 21 to 25 - $50
[ ] 19 to 20 - $25
[x] 0 to 18 - $100

Total so far:  $200

Birth Order:
[ ] Twins or more than twins - $750
[x] First born - $320
[ ] Only Child - $250  
[ ] Second born - $150
[ ] Middle child - $100
[ ] Last Born - $100
[ ] Third born - $550-
[ ] Fourth born - $300
[ ] Fifth born - $400
[ ] Sixth born -$215

Total so far: $520


Drink?
[ ] I did like once - $400
[ ] Only Holidays - $250
[ ] Sometimes - $215
[x] YES - $200
[ ] Only weekends - $300
[ ] Every other day - $50
[ ] Once a day -  $15
[ ] I live from the bottle - $Bankrupt$
[ ] No - $600

Total so far: $920


Vision?
[ ] perfect vision - $400
[ ] need or have glasses/contacts but don't wear them - $200
[ ] No correction - $100
[x] Glasses - $50
[ ] Contacts - $25
[ ] Surgical correction - $100

Total so far: $970

Shoe Size:
[ ] 13+ - $300
[ ] 12 and a half to 13 - $250
[x] 11 to 12 - $400
[ ] 7 to 10 - $50  
[ ] Under 7- $450

Total so far:  $1,370

Favorite Colors (limited to 5 only.):
[x] Green - $750
[x] Red - $600
[x] Black - $100
[ ] Yellow -$475
[ ] Brown - $300
[x] Purple - $225
[ ] White - $400
[x] Aqua - $350
[ ] Orange - $300
[ ] Blue - $300
[ ] Pink - $100
[ ] Other - $500

Total:  $ 3,395

Did you use a calculator to add it all up?
[ ] Yes - $0
[ ] Nope - add $1000
[x] some - $750 -- to make sure I did the math correctly.

Sub Total: $4,145