出生信息 Birth Information
I'm collecting this information from volunteers for some very informal research on astrology and other divination methods in the Chinese tradition. I will not share this information with any other third party without your prior agreement. If you'd like to know more about my analysis (it will be prudent) of your birth information, please email me at hooraypublic@gmail.com
姓 Last Name *
Your answer
名 First Name *
Your answer
出生性别 Birth Gender *
请选择出生时的生理性别,无论后来是否改变性别。Please choose your gender when you were born, regardless if you have changed gender since.
出生日期 Birth Date *
MM
/
DD
/
YYYY
出生时间 Birth Time *
Time
:
出生城市 Birth City *
请填写出生的城市名。如果你不在城市出生,请填写最靠近的城市名。Please provide the name of the city or town where you were born. If you are not born in one, provide the name of the closest major city.
Your answer
出生国家 Birth Country *
Your answer
电子邮箱 Email Address
如果你愿意,可以留下联系邮箱。If you'd like, please leave your email address.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.