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Date of Birth

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Zip/Postal Code

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How did you hear about us?

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Undergraduate School

Minor Education

Education Level

Major In

Graduate School

Graduate School Degree Received

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

About Me (Who I am)

Do you have children?

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

Occupation

Willing to relocate

Relocate Where?

Ethnicity

Religion

Animals I Like

Allergic To

Hobbies

Are you a vegetarian?

Enter any dietary restrictions you have

Favorite Food

What types of instruments do you play?

Politically you are?

Are you more old-fashioned? (Man pays, feminine address, Mom raises children) or Modern day? (Pay 50/50 for dinners and nannies for kids)

Do you have a positive outlook and think things will turn out for the best or do you worry about things that could go wrong?

What do you do on the weekends and in your spare time?

The five items you can't live without are

What are the three things for which you are most thankful?

What is the first thing people notice about you?

Favorite Music

Favorite Films

Annual Income

Smoking Habits

Drinking Habits

Exercise Habits

Name three of your favorite travel destinations

Name three destinations you'd like to travel to

Are your parents still married?

If yes, how long have they been married? (Years)

If no, how old were you? (Years)

What is your relationship like with your family? Are you close?

Is family important to you? How often do you speak with them?

What is your ethnic origin? What generation?

The most important relationship

Do you like children?

Do you want to have children?

Relationship Expectations

No. of children

Any serious medical conditions?

Been a patient at mental health facility?

Been convicted for crime?

If yes to any of above, please explain

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