Please Be As Thorough As Possible.
This Will Assist Us In Getting You Quicker Results!
You do not have to answer any questions you feel are not appropriate!

Please Fill Out Both Part 1 & 2 Of This Form

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Part 1 : Member Information

 

Name
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Male Female Age
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Nationality
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Weight
Hair Color
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Occupation

Education

Do you Smoke Yes No
Do you Drink Yes No Socially
What is your First Language

What languages do you speak?

Other

What is your Religion

Other

I attend Church:

Political Feelings

Hobbies

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Athletic Activities

Other

Musical Taste

Other

Which rules you more?

The head The heart

Do you prefer?

A large group of friends A small group of friends

Viewing Interests

Other

What general activities do you enjoy the most?

Part 2: Information About the Companion You Seek

 

Smoker Nonsmoker

Their Religion

Other

Attend Church:

Weight

Height

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Age

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Education

What are the most important characteristics you are looking for in a companion?

Which of the following best describes your view of a future spouse?

What are the three most important things about yourself?

Your Final Comments

Please indicate the cities and/or countries where you would like to find your "Special Someone"

Photograph

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OPTIONAL INFORMATION

Is there anything about our questionnaires you feel we could improve upon?

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The Three Month Membership is $595.00

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If you prefer, you may send us your application by mail.  Your membership will be activated upon receipt.  Please make payment out to "Intro World International" and mail to our international office at:

GLI c/o Intro World Int'l
377 East 35th Ave.
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