Mrs.

Miss

Ms.

?????????

Last Name: First Name:

Address:

Favorite State Capital:

(Continental U.S. Only!)

City:

Mother's Maiden Name:

If, For No Good Reason, You'd Like to Give Money To A Total Stranger . . .

I am accepting::

• $10
• $20
• $50
• $100
• $1 thousand
• $1 million
• and pizza