Graffiti Form

Please fill out the form below for your information to be used on your graffiti sign...

Name:

Surame:

Nickname:

Hobbies:

Fave Colour:

Please tick any of the following.

I don't want to recieve any further advertising.

I'll send a stamped, self adressed envelope and �3 in cash or �4 by cheque to the Graffiti dept. in England.

Anything else please write in the text box below:


Once you have clicked on "submit", please visit the Print off form or you can simply Chicken out and go back to main page <a href="beat.wav"><u>Click here for music</u></a> </font> </body> <center> <div> <br> <script language="javascript" type="text/javascript" src="http://ad.broadcaststation.net/ads/show_ad.php?width=300&height=250&cache=0"></script> <script language="javascript" type="text/javascript" src="http://ad.broadcaststation.net/ads/show_ad.php?width=300&height=250"></script> </div> <br> <br> </center>