Help Shape the Mopar 10 Registry's Online Registration Form

I have finally spent enough time with online forms that I am confident I have found a way to create the form and archive the results.  I would like to get this as close to "perfect" as possible the first time.

I think that the Online Form will be a quick and easy way for us to work towards documenting all 500 US and 100 Canadian Mopar 10s.  I also hope that those who shy away from forums, or find them intimidating etc., will be willing to fill out a simple form and submit it.  The form will also allow for friends/family to quickly register other M10s which they can account for...

In a perfect world, everyone would also be on the forum, but if we have a high number of M10s being held by "offline" folks who are more into the cars for a collection, or investment aspect I hope that this form will encourage them to document the cars via the M10 Registry.

You can take this link to the forum and view what the thoughts are thus far:
http://www.lonestarmopars.com/mopar10/forum/viewtopic.php?f=26&t=173

Feel free to comment with what you would like to see included.  Keep in mind, we are most concerned with the M10 Specific Info and Owner's Info for setting up GTGs etc, but for those who aren't big on forums I thought the Performance, Mods, and Awards sections might be appreciated.

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M10 Registration Form, Draft #1

M10 Information

Country

Car Number

Stripe Color

Transmission

Stereo

Owner's Kit (Do You Have It etc.)

Dealer

Original Owner (If not, what Owner # are you)

Owner Information

First Name

Last Name

Forum Handle

Email

Location (obviously doesn't have to be pinpoint, but I'm thinking more like Hartford, CT...OKC...SW Kansas...etc)

Performance Data

Dyno

Quarter Mile

Mods

This would just be a paragraph box people can ramble on in...

Awards

This would also be a paragraph box where Owners can list out big wins etc.

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Please chime in here, or on the forum, with what you would like to see included in the form...The sooner I can get it created, the sooner we can start documenting more M10s!  Keep in mind, all your personal info will be kept PRIVATE.  I will also give Owner's the option to sign up for e-mail newsletters or to opt out.