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| Please complete our confidential questionnaire and a representative will contact you: |
| ? |
| 2) I would like a partner who is the "life of the party." |
| 3) I am a very affectionate person and long for the same. |
| 4) I set goals in my life and strive to achieve them. |
| 5) I am happiest when in love and don't like being alone. |
| 6) I am open minded and wear my heart on my sleeve. |
| 8) Respect is very important in a relationship. |
| 9) It is important that my mate and I are on the same intellectual level. |
| 10) It's important that my mate and I share the same cultural, ethnic and religious backgrounds. |
| Which of the following have you utilized to meet people? (check all that apply) |
| Which of the following make it a challenge to meet people? (check all that apply) |
| I'm not comfortable in the social scene. |
| I'm a single person with children. |
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