Activity 4
Website Registration Form
Alex Kuchar
Please fill out the form below.
First Name:
Last Name:
Email Address:
Preferred Contact Method:
Email
Phone
Interests:
Music
Sports
Movies
Comments:
Date:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035