| 1. First Number.............. (Choose any number you want) |
| 2. Second Number......... (Choose any number you want) |
| 3. 1st person's
name....... (opposite sex & you
know him/her well) |
| 4. 2nd person's name...... (friend or family member) |
| 5. 3rd person's
name....... (riend or family
member) |
| 6. 4th person's
name....... (friend or family
member) |
| 7. 5th person's
name....... (opposite sex & you
know him/her well) |
| 8. Song #1..................... (any song that you like) |
| 9. Song #2..................... (any song that you like) |
| 10. Song #3................... (any song that you like) |
| 11. Song #4................... (any song that you like) |
|