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| About You |
FIRST
NAME:
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LAST
NAME:
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Year
of Birth:
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EMAIL:
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HEIGHT:
(for car fitting)
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ADDRESS:
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CITY:
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STATE:
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ZIP:
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COUNTRY:
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DAYTIME
PHONE:
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EVENING
PHONE:
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FAX:
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| Your Intentions |
I
am interested in...
2
Day Rally School
3
Day Rally School
4
Day Rally School
Security
School
Winter Safety
School
Rally Experience
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| You
are contacting us to:
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What
is your intention of this school?
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| What
month would you be most interested in attending?
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Have
you been to Team O'Neil Rally School before?
If so, when?
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| What
year did you start driving?
How
should we contact you? Phone
Email
Mail
Would you like additional literature via mail? Yes
No
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How
did you hear about us?
If
applicable, what person, magazine, newspaper or event?
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| Marketing / Demographic Info |
What type of vehicle do you drive?
Subaru,
VW,
Audi,
BMW,
Ford,
Chevrolet,
Other (please List)
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Education Level:
High school graduate
Did not graduate high school
College degree
Some college |
| What age group are you in?
Under 18,
18-34,
35-55,
Over 55 |
| What is your household income?
Under $25K,
$25-50K,
$50-100K,
Over $100K |
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I would like to receive the Quarterly School Newsletter
I would like to receive the Rally Newsletter
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Security Code
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Please type in the input box the letters which are displayed
in this image.
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