Name__________________________Age_______Sex _________Date of Birth ______________
Height ______________ Weight ________________Marital Status _________________________
Nationality _______________________Race_________________English Level_______________
Education ______________________________ Occupation ______________________________
Mailing address _________________________________________________________________
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Phone ____________________________________E-mail _______________________________
Interests and hobbies _____________________________________________________________
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Self descriptions_________________________________________________________________
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Ideal Match ____________________________________________________________________
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Other comments _____________________________________________________________________________
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Where do you want your profile to be posted: Internet (open)_________ Intranet(closed)_______
Your signature ____________________________ Date______________________________