Name Dale o UI
Choose from the following reasons why you
"Using the diagram, indicate exactly
a little bitch: where the internet bad touched you
Host an argument
My opinion was wrong
[ZL found something offensive online
and couldn't move ont
OO have no sense of humour No one will let me suck their dick
 Someone was rude back to me
OO have nothing better to do
Do you require medical assistance tissues? Yes No
On a scale of 1
10 (1 being mild anal itching
and 10 being crippling agony) how much 123456789 10
does your butthurt hurt?
Have you ever considered not being a
Does reporting things make you moist? Yes No
Use this section to provide any extra information you think relevant
(use separate sheet if necessary)
Once fnisnes, seal rs compete form inside an unaddressed envelope and post up your fucking are, cun.
BAPOT-CUNT. Page 10"