Athletic Interest:
Very Active   Active
Occasionally Does not matter

Religion:
Protestant Catholic Jewish
None Does not matter
Other

Children:
Has Children Does Not Have Children Desires Children Does not matter

Marital Status:
Never Married Divorced Widowed Does not matter

Cultural Interests:
Theater Dance Music
Visual Arts Film Does not matter
Other

My Single Status:
Never Married
Divorced years months
Separated years months
Widowed years months

I Am:
Not dating anyone I would consider for a long-term relationship
Dating various people
Dating someone who does not want what I want in a relationship

My Education Level Is:
High School
Jr. College/Trade/Technical
4-Year College/University
Masters Degree
Advanced Degree

My Annual Income Is:
Under $15,000
$15,000 to $25,000
$25,000 to $35,000
$35,000 to $50,000
$50,000 to $100,000
$100,000+

Are You Planning to Move in the Next Six (6) months?
Yes No
If "yes", where?

My Typical Work Week Is:
9 to 5
Afternoon thru evening
Late-night shift
My time is my own
I am not working now

Height (feet) 1 2 3 4 5 6 7 8 9 (inches) 0 1 2 3 4 5 6 7 8 9 10 11 Weight 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9

Occupation