Your Name?
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| Your Address? |
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| Your City? |
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Your State?, Your zip?
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| Your Age? |
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| Your Date of Birth? |
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| Your Sex? |
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| Your Race? |
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| Your Religion is? |
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| Your Religious Convictions? |
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| Do You (Would You)
Date Member of Other Religions? |
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| Do You (Would you)
Date Members of Other Races? |
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| What Yearly Income Do You Consider Adequate? |
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| Where Do You Go When You Date? |
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| Do You Have Pets?, Love Animals? |
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| If You Had A Choice Between
Dog or Cat, Which Would You Chose? |
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| Do You Use Alcohol? |
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| Will You Consider Prospects
Who Smoke And Are Trying To Quit? |
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| Do You Have Children? |
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| What Is You Martial Status? |
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| How Long Have You Lived In The Community? |
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| What Type Of Music Do You Enjoy? |
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| Your Educational Background? |
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| Your Height Is? |
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| Would you consider a
prospect who drinks in moderation? |
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| What type of home appeals mostly to
you? |
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| What is your opinion
of X-RATED movies? |
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Where would you live if you had a choice?
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| Do you approve of couples
who decide not to have children? |
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| Your idea of a pleasant evening? |
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| Your astrological sign? |
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| Are you looking for marriage? |
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| What qualities do you look for in a
date? |
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| How often would you like to date? |
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| Do you consider yourself attractive? |
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| Do you feel its acceptable
for unmarried couples to live together? |
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| Do you like children? |
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How nearby should your dates live?
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| At a party among strangers, you would
probably? |
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| When are you usually most alert? |
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| Which of the following words best describe
you? |
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| Your schooling completed? |
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| Your Occupation? |
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| Do you smoke? |
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| By which of your parents, were you raised? |
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| Alone, by yourself, do you enjoy spending
your evening? |
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| What types of TV programs are enjoyable
to you? |
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| Which following words best describe
you? |
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| Which Activities Are Most Enjoyable
To You? |
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| Raising As A Child, Describe Your Childhood? |
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| Your Age Group Comfortable When Dating? |
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| What Was Your Past Relationship Like,
During Previous Dating? |
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| My Occupation is? |
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In My Life I Really Want Mostly?
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| My Weight is? |
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| To My Happiness, Romantic Love is Essential? |
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| Important Characteristics
Of Importance On A Date? |
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| Your E-mail Address? |
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| Sexual Orientation? |
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| What Color is Your Hair? |
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| What Is The Length Of Your Hair? |
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| What Are Your Facial Features? |
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| What Is Your FAVORITE
Type of Food |
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| What is MOST
important to you in a relationship |
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| If you could change one thing about
you, what would change? |
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| My sexiest body part is my? |
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| What color are your eyes? |
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| What is your favorite hobby |
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