Your name:

Your email:

The name you want displayed:

Instant messenger where Jack can get ahold of you for Random Chances of Coolness:

Messenger format (AIM, Yahoo, MSN, etc...)

Do you want your information displayed on the website?

If displaying your information, do you want your e-mail address withheld?

Select one of these:

If refered by a friend who already has Jack points, Who?

If other, How did you hear about the Cool Factor?

What is your Cool Catchphrase?

What is your favorite drink?

What is your favorite non-alcoholic drink?

Name one person who is "Cooler than you"

If you created your own dance move, what would it be called?

What is your "Theme Song?"


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