Please fill out this form and return it to Olsen 304 or email it to robotlab@cs.uml.edu. Participants will be picked based on availability and the information provided in the survey. All information will be kept confidential. Limited Spaces are available, so please respond quickly.

Name:

Contact Phone Number:

Email Address:

Times Available to Test. (A testing session will take roughly 2 hours.)

	Sunday    01/02/05:

	Monday    01/03/05:

	Tuesday   01/04/05:

	Wednesday 01/05/05:

	Thursday  01/06/05:

	Friday    01/07/05:

	Saturday  01/08/05:

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	1) How many hours a week do you play video games?    ______ 

	2) Which of the following platforms do you own (and use)?
	   __ PC        __ PlayStation 1  __ PlayStation 2 
	   __ X-Box      __ GameCube      __ GameBoy       
	   __ Other (Please Specify) 
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	3) What genre(s) of video games do you play the most?
	   __ First-Person Shooter (Doom, Half-Life, etc) 
	   __ Action/Adventure (Tomb Raider, Grand Theft Auto, etc) 
	   __ Real-Time Strategy (Warcraft, Age of Empires, etc) 
	   __ Sports (Madden, etc) 
	   __ Racing (Gran Turismo, Formula1, etc) 
	   __ Simulators (Flight Simulator, The Sims, etc) 
	   __ Puzzle/Board Games (Chess, Tetris, etc) 
	   __ Role-Playing Games (Everquest, Baulder's Gate, etc) 
	   __ Other(s) -- Please specify below 
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	4) What game title(s) do you play the most now?
 
 
	5) Name a couple of your all-time favorite games?