Personal Profile Submission Form

Yes, I would like to use the following services:

  Starter Help Package

 

Please only include the information that you want to be used in your profile (that ladies can use for their information about you and as the means of contacting you).

 

Phone/fax numbers are only featured in the catalogue for agencies and are not published on the Internet. If you do not want some details to be featured in your profile, do not submit them.

 

We need at least 2 names for identification purposes (First Name + Surname OR First Name + Nickname).

 

First Name
Surname (or Nickname)
Address
City
State/Province
Postal code/ZIP
Country
Phone
FAX
E-mail

 

Please describe yourself:

 

Age*
Height*
Weight*
Hair color	Red Light blonde Medium blonde Dark blond Brown Black Gray
Eye color	Green Blue Brown Black Gray Violet
Race	Caucasian/White African/Black Asian Hispanic Multiracial Other

 

 

Marital status*:

single  divorced  widower  married/separated

 

Do you have children?  no     yes

If yes, please specify gender and age.

 

Education* (you can choose several options):

 

school
special
college
university
postgraduate

Occupation*:

Languages*: (please mark if you can communicate in the language):

English
German
French

Spanish
Italian
Russian

Other:

Interests and hobbies* (max 200 characters, with spaces):

 

Personality* (max 200 characters, with spaces):

 

Religion*:

Drinking*

no  socially  sometimes  heavily - please, help!

 

Requirements to a partner

(If parameter is not important for you, leave the windows blank.)

 

Age:		from to
Height:		from to
Build:		doesn't matter  slim  average plump
Kids OK?		OK 1 child acceptable no kids
Other requirements (woman's personality, interests, education etc - max 200 characters, with spaces)

 

 

 

Your Message* (maximum 1000 characters, with spaces):

 

I understand that the data I will receive are intended solely for my personal use, and may not be sold or in any other way distributed to a third party.

 

Check the information before submitting, particularly your email address. Please press the button only ONCE, it will take a few seconds to receive a confirmation.