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	Name	*
	E-mail	*
	Age	*
	Current Website URL (if you have one)
	Example(s) or work	*
	Package	Midori Pinku Murasaki *
	Subdomain Name you.tokyoberry.com (free only)
	Tell me about the site you want to make	*
	Tell me about you (hobbies, music ect)	*
	Comments/Suggestions