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State/Province	--Select-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -- Other US -- Puerto Rico US Territory (other) --Select--
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Date of birth	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
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I will probably visit this TSC location:	--Select-- Arlington Park or Arlington OTB Location Churchill Downs or Louisville Trackside Calder Race Course Hoosier Park or Indiana OTB Location Other Ellis Park Hollywood Park Trackside OTB: Chicago, IL Trackside OTB: Ft. Wayne, IN Trackside OTB: Indianapolis, IN Trackside OTB: McHenry, IL Trackside OTB: Merrillville, IN Trackside OTB: Quad Cities Trackside OTB: Rockford, IL Trackside OTB: South Elgin, IL Trackside OTB: Waukegan, IL TVG Other track or OTB Other phone or internet account N/A Trackside OTB: South Beloit, IL Fair Grounds Race Course
I visit the track or OTB:	--Select-- Once a week or more 2 - 3 times per month Once per month Less than once per month 2 - 3 Times per week 4 or more times a week NA
Handicapping Level	--Select-- Beginner Expert Intermediate I know a few things but I'm still learning N/A
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