<form action='http://www.kwiz.biz/simplesurveys/do-survey.php' method='post' target='_new'><table border=1 bordercolor=#efefef cellspacing=0><tr><td valign=top align=right>What is your name?</td><td align=left>Jackson<input type='hidden' name='question1' value='What+is+your+name%3F'><input type='hidden' name='type1' value='1'></td></tr><tr><td valign=top align=right>What other nicknames do you have?</td><td align=left>Jax, Jiggity, Action<input type='hidden' name='question2' value='What+other+nicknames+do+you+have%3F'><input type='hidden' name='type2' value='1'></td></tr><tr><td valign=top align=right>What breed are you?</td><td align=left>Pomeranian<input type='hidden' name='question3' value='What+breed+are+you%3F'><input type='hidden' name='type3' value='1'></td></tr><tr><td valign=top align=right>Where were you born?</td><td align=left>California<input type='hidden' name='question4' value='Where+were+you+born%3F'><input type='hidden' name='type4' value='1'></td></tr><tr><td valign=top align=right>Where do you live now?</td><td align=left>California<input type='hidden' name='question5' value='Where+do+you+live+now%3F'><input type='hidden' name='type5' value='1'></td></tr><tr><td valign=top align=right>What is your favorite toy?</td><td align=left>Camp Yappy<input type='hidden' name='question6' value='What+is+your+favorite+toy%3F'><input type='hidden' name='type6' value='1'></td></tr><tr><td valign=top align=right>What is your favorite store?</td><td align=left>Petsmart<input type='hidden' name='question7' value='What+is+your+favorite+store%3F'><input type='hidden' name='type7' value='1'></td></tr><tr><td valign=top align=right>How many toys do you have?</td><td align=left>Too many to count<input type='hidden' name='question8' value='How+many+toys+do+you+have%3F'><input type='hidden' name='type8' value='1'></td></tr><tr><td valign=top align=right>What brand of food do you eat?</td><td align=left>Eukanuba Small Bites<input type='hidden' name='question9' value='What+brand+of+food+do+you+eat%3F'><input type='hidden' name='type9' value='1'></td></tr><tr><td valign=top align=right>Wet or dry food?</td><td align=left>Dry<input type='hidden' name='question10' value='Wet+or+dry+food%3F'><input type='hidden' name='type10' value='1'></td></tr><tr><td valign=top align=right>What is your favorite color?</td><td align=left>Blue<input type='hidden' name='question11' value='What+is+your+favorite+color%3F'><input type='hidden' name='type11' value='1'></td></tr><tr><td valign=top align=right>Are you bad when nobody's looking?</td><td align=left>Bad to the bone<input type='hidden' name='question12' value='Are+you+bad+when+nobody%5C%27s+looking%3F'><input type='hidden' name='type12' value='1'></td></tr><tr><td valign=top align=right>Are you friendly?</td><td align=left>Yes<input type='hidden' name='question13' value='Are+you+friendly%3F'><input type='hidden' name='type13' value='1'></td></tr><tr><td valign=top align=right>Are you overweight?</td><td align=left>No<input type='hidden' name='question14' value='Are+you+overweight%3F'><input type='hidden' name='type14' value='1'></td></tr><tr><td valign=top align=right>Do you eat people food?</td><td align=left>No<input type='hidden' name='question15' value='Do+you+eat+people+food%3F'><input type='hidden' name='type15' value='1'></td></tr><tr><td valign=top align=right>Do you eat bugs?</td><td align=left>Sometimes<input type='hidden' name='question16' value='Do+you+eat+bugs%3F'><input type='hidden' name='type16' value='1'></td></tr><tr><td valign=top align=right>Do you live with other animals?</td><td align=left>Yes- Salem and Peanut Butter (crazy cats)<input type='hidden' name='question17' value='Do+you+live+with+other+animals%3F'><input type='hidden' name='type17' value='1'></td></tr><tr><td valign=top align=right>Do you like to exercise?</td><td align=left>Yes<input type='hidden' name='question18' value='Do+you+like+to+exercise%3F'><input type='hidden' name='type18' value='1'></td></tr><tr><td valign=top align=right>Do you like car rides?</td><td align=left>Most definitely<input type='hidden' name='question19' value='Do+you+like+car+rides%3F'><input type='hidden' name='type19' value='1'></td></tr><tr><td valign=top align=right>Do you get into stuff?</td><td align=left>No<input type='hidden' name='question20' value='Do+you+get+into+stuff%3F'><input type='hidden' name='type20' value='1'></td></tr><tr><td valign=top align=right>Do you like to swim?</td><td align=left>I like to sit on my float in the pool<input type='hidden' name='question21' value='Do+you+like+to+swim%3F'><input type='hidden' name='type21' value='1'></td></tr><tr><td valign=top align=right>What is your favorite treat?</td><td align=left>Bones, beggin strips, snausages<input type='hidden' name='question22' value='What+is+your+favorite+treat%3F'><input type='hidden' name='type22' value='1'></td></tr><tr><td valign=top align=right>Do you shed?</td><td align=left>No<input type='hidden' name='question23' value='Do+you+shed%3F'><input type='hidden' name='type23' value='1'></td></tr><tr><td valign=top align=right>What's the funniest thing you ever did?</td><td align=left>Fart and look back to see where it came from<input type='hidden' name='question24' value='What%5C%27s+the+funniest+thing+you+ever+did%3F'><input type='hidden' name='type24' value='1'></td></tr><tr><td valign=top align=right>What's the bravest thing you ever did?</td><td align=left>Jumped in the pool after Kelsey when she slipped in<input type='hidden' name='question25' value='What%5C%27s+the+bravest+thing+you+ever+did%3F'><input type='hidden' name='type25' value='1'></td></tr><tr><td valign=top align=right>Are you neutered?</td><td align=left>Damn humans!<input type='hidden' name='question26' value='Are+you+neutered%3F'><input type='hidden' name='type26' value='1'></td></tr><tr><td valign=top align=right>Are you a social animal?</td><td align=left>Yes<input type='hidden' name='question27' value='Are+you+a+social+animal%3F'><input type='hidden' name='type27' value='1'></td></tr><tr><td valign=top align=right>Collar or harness?</td><td align=left>Just upgraded to a harness<input type='hidden' name='question28' value='Collar+or+harness%3F'><input type='hidden' name='type28' value='1'></td></tr><tr><td valign=top align=right>Retractable or regular leash?</td><td align=left>Retractable<input type='hidden' name='question29' value='Retractable+or+regular+leash%3F'><input type='hidden' name='type29' value='1'></td></tr><tr><td valign=top align=right>Ceramic, Metal or Plastic bowls?</td><td align=left>Ceramic<input type='hidden' name='question30' value='Ceramic%2C+Metal+or+Plastic+bowls%3F'><input type='hidden' name='type30' value='1'></td></tr><tr><td valign=top align=right>Do you sleep in a crate?</td><td align=left>No<input type='hidden' name='question31' value='Do+you+sleep+in+a+crate%3F'><input type='hidden' name='type31' value='1'></td></tr><tr><td valign=top align=right>Do you have a dog bed?</td><td align=left>More like three queen size beds<input type='hidden' name='question32' value='Do+you+have+a+dog+bed%3F'><input type='hidden' name='type32' value='1'></td></tr><tr><td valign=top align=right>Do you have a doghouse?</td><td align=left>Yeah, it's 2000 square feet<input type='hidden' name='question33' value='Do+you+have+a+doghouse%3F'><input type='hidden' name='type33' value='1'></td></tr><tr><td valign=top align=right>Do you belong to any dog clubs?</td><td align=left>No<input type='hidden' name='question34' value='Do+you+belong+to+any+dog+clubs%3F'><input type='hidden' name='type34' value='1'></td></tr><tr><td valign=top align=right>How does your owner describe you?</td><td align=left>Awesome!<input type='hidden' name='question35' value='How+does+your+owner+describe+you%3F'><input type='hidden' name='type35' value='1'></td></tr><tr><td colspan=2 align=center><input type='submit' value='Take This Survey'>
</td></tr></form></table>

<ahref="http://blingee.com/blingee/view/24257593-Jax" target="_blank" title="Personalized Glitter Graphics">

<table width="400" cellpadding="0" border="0"><tr><td align="left" valign="bottom" width="85" height="30"></td>
<td align="left" valign="bottom"></td>
</tr></table>