Put an x in front of the things that apply to you.
Have you ever...
( ) smoked a cigarette
( )moked a cigar.
( )smoked a joint
( ) crashed a friend's car
( )stolen a car
( ) been in love
(x) been dumped
() shoplifted
( ) been fired
() been in a fist fight
(x) snuck out of my parent's house
(x) had feelings for someone who didn't have them back
( ) been arrested
(
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