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Exit Survey
 
 
Here's where you can tell us about yourself and what you are looking for in a life partner.


 
 
 
* Upload your photo here:
 
 
 
Name
   
 
 
 
Age
   
 
 
 
Marital Status
 
Single
 
Divorced
 
Separated
 
Widowed
 
Widower
 
 
 
Height
   
 
 
 
Weight
   
 
 
 
Your smoking habits
 
 
Do smoke
 
Don't smoke
 
Occasionally smoke
 
 
 
Your drinking habits
 
Do drink
 
Don't drink
 
Occasionally drink
 
 
 
Sports & Exercise
 
Very active
 
Active
 
Some
 
None
 
 
 
Do you have dependents living with you?
 
No children
 
1
 
2
 
3
 
More than 4
 
 
 
Do you want children?
 
Want children
 
1
 
2
 
3
 
More than 4
 
Don't want children
 
 
 
Are you willing to relocate?
 
Willing to relocate
 
Not willing to relocate
 
Not sure about relocating
 
 
 
Please write a short bio about yourself.
   
 
 
 
What is the age range of the lady that you are looking for?
 
20 - 30 yrs old
 
31 - 40 yrs old
 
41 - 55 yrs old
 
 
 
Do you have a preferred height?
   
 
 
 
Do you have a preferred weight?
   
 
 
 
Do you have a preferred education level?
   
 
 
 
Is it okay if the lady has children ?
 
No child/children
 
1
 
2
 
3
 
4 or more
 
 
 
Would you like a lady who wants child/children?
 
Yes
 
Not sure
 
Don't want anymore
 
 
 
Her preferred English level?
   
 
 
 
Her drinking habits?
 
Do drink
 
Don't drink
 
Occasionally drink
 
Not important
 
 
 
Her smoking habits
 
Do smoke
 
Don't smoke
 
Occasionally smoke
 
Not important
 
 
 
Her sports & exercise
 
Very active
 
Active
 
Some
 
Not important
 
 
 
Is it important for her to relocate
 
Willing to relocate
 
Not important
 
Not sure about relocate
 
 
 
What are the qualities of the lady that you are looking for?