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personals.
About you: (please print clearly)
Referred by:_________________
Name:______________________________________________________________
Age:_______
Birth date: ___________
Address: ____________________________________________________________
___________________________________________________________________
___________________________________________________________________
Physical
Description (Include two photos - 1 half body, 1 full body)
Height: ________ Weight: ________ Eye color
__________ Hair color _________
Marital status: ______________ # of children ____________
Religion __________________________________
Smoker
__________ Drinker ____________ Illegal drug user _____________
Education ___________________________________________________________
Occupation:
_________________________________________________________
Hobbies/Interests: _____________________________________________________
___________________________________________________________________
Languages
spoken: ____________________________________________________
Traveled abroad ______ where __________________________________________
Do
you have: telephone_______ telephone number: ___________________________
Do you have: email:_______ email address
______________________________
Self description ______________________________________________________
___________________________________________________________________
___________________________________________________________________
Purpose
of publishing : ______ friendship only ______ find my lifetime partner
______ have new friends, maybe find my lifetime partner
About the men you want to correspond with:
Age: minimum
______ maximum ______ height: _________ weight: ___________
Racial preference: (White,
Black, Asian, other, or no preference):
___________________________________________________________________
Status:
(respond yes, no, maybe)
Single, never married _________ Divorced __________
Has children ________ Does not have children ________
Religion:(Catholic, Christian, other or any religious
faith):
____________________________________________________________________
Habits:(respond - no, moderate OK or OK)
Drinker: _________ Smoker: _________ Illegal drug use: ___________
Education: ___________________________________________________________
Profession/occupation:
__________________________________________________
Character: ___________________________________________________________
___________________________________________________________________
Your
signature: _________________________________ Date: _________________
Submit this form with two photos
and short hand written letter introducing yourself (suitable for publication) to:
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