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Name
Email Address
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Date of Birth
January
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December
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2004
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2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Time of Birth
(Use 12pm if unknown)
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AM
PM
Place of Birth
Town / City
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua & Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Azores (part of Portugal)
Bahamas
Bahrain
Bangladesh
Barbados
Barbuda (Antigua)
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bophuthatswana
Borneo
Bosnia & Herzegovina
Botswana
Brazil
British Honduras (Belize)
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma (Myanmar)
Burundi
Cambodia (Kampuchea)
Cameroon
Canada
Canal Zone
Cape Verde Islands
Cayman Islands
Central African Republic
Ceylon (Sri Lanka)
Chad
Chile
China
Ciskei
Colombia
Comoros Islands
Congo
Congo Democratic Republic
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Dahomey
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
Eire
El Salvador
England
Equatorial Guinea
Eritrea (Ethiopia)
Estonia
Ethiopia
Faeroe Islands
Falkland Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Ireland Northern
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Java
Jersey
Jibuti
Jordan
Kampuchea (Cambodia)
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldive Islands
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Midway Island
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Muscat & Oman
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Ireland
Norway
Oman
Pacific Islands Trust Territory
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Portuguese Guinea
Portuguese Timor
Puerto Rico
Qatar
Reunion
Rhodesia (Zimbabwe)
Romania
Russia
Rwanda
Saint Christopher(Kitts)-Nevis
Saint Helena
Saint Lucia
Saint Pierre & Miquelon
Saint Vincent & Grenadines
San Marino
Sao Tome & Principe
Saudi Arabia
Scotland
Senegal
Serbia & Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & S.Sandwich
South Korea
South West Africa (Namibia)
Southern Yemen
Spain
Spanish North Africa
Sri Lanka
Sudan
Surinam
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau Island
Tonga
Transkei
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu Islands
USA
U.K. England
U.K. N.Ireland
U.K. Scotland
U.K. Wales
Uganda
Ukraine
United Arab Emirates
Upper Volta (Burkina Faso)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venda
Venezuela
Vietnam
Virgin Islands
Wake Island
Wales
Wallis & Futuna
West Germany
Western Sahara (Morocco)
Western Samoa
Yemen (N & S)
Zaire
Zambia
Zimbabwe
State
(USA only)
-- none --
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
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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