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First Name
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Email
Address
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State
Zip
Age	18-21 22-27 28-35 36-42 43-48 49-55 56-62 63-68 69-75 76-82 83 or over
Education	Some High School High School Graduate Some College Bachelor Degree Masters Degree Doctorate Degree
Gender	Female Male
Occupation
Income	Under $15,000 $16,000-$25,000 $26,000-$35,000 $36,000-$45,000 $46,000-$52,000 $57,000-$65,000 $58,000-$65,000 $66,000-$75,000 $75,000-$85,000 $85,000-$100,000 Over $100,000
Number of Children
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Username
Password
	How did you hear about BLACKWEEKLY.COM
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	internet weekly?
	What type of infomation would you like find at
	BLACKWEEKLY.COM?
	please limit you ideas to 100 words or less
Hobbies
Music	Rap Hip-hop R&B
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Profile	Tell us about yourself Please limit your profile to 500 words or less
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