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Education Level

Undergraduate School

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Major In

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Willing to relocate

Hair Color

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Body Type

Height

Weight

Annual Income

Languages Spoken (fluent)

Where did you grow up?

Do you have any siblings?

What religion were you born with?

What religion are you currently practicing?

Ethnicity

What is your ethnic origin? What generation?

Marital Status

In a relationship?

Past Relationship Comments

Do you have children?

No. of children

If you have children, list age and sex:

Do you want to have children?

Would you date somebody who has children?

Been convicted for crime?

If yes to any of above, please explain

Do you have an alcohol and/or drug addiction?

Smoking Habits

Drinking Habits

Exercise Habits

Animals I Owned

Allergic To

Enter any dietary restrictions you have

I am (An Introvert is a 0, and Extrovert is a 10)

About Me (Who I am)

Describe what you are looking for in the person you want to meet

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Match Age	to	to

Match Dealbreakers

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Match Wants to have children?

What is more important: looks or money?

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Match Religion

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Match Ethnicity

List any ethnicities you will NOT date

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Match Height	to	to

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