Hair Color:
[ ] Brown - $100
[ ] Blond - $50
[x] Black - $15
[ ] Bald - $5
[ ] Other-$75

Total so far: $15


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

Total so far: $90


Height:
[ ] Over 7′ - $200
[ ] 6′8″ to 7′ - $175
[ ] 6′0″ to 6′7″ - $150
[ ] 5′5″ to 5′11″ - $75
[ ] 5′4″ to 5′10″ - $85
[x] Under 5′4 - $275

Total so far: $365


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: $465


Birth Order:
[ ] Twins or more than twins - $750
[ ] First Born - $320
[ ] Only Child - $250
[ ] second born - $150
[ ] Middle child - $100
[x] Last Born - $100
[ ] third born - $550
[ ] fourth born - $300
[ ] fifth born - $400
[ ] sixth born -$215

Total so far: $565


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

Total so far: $815

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

Total so far: $1215


Shoe Size:
[ ] 13+ - $300
[ ] 12 and a half to 13 - $250
[ ] 11 to 12 - $400
[x] 7 to 10 - $500
[ ] Under 7- $450

Total so far: $1715


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

Total: $2415

Did you use a calculator to add it all up?
[ ] Yes $0
[ ] Nope - $1000
[x] some- $750

Final Total: $3165

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