Alina
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Snezhana
Alena
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Liaysan
Olga
Anna
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Please fill out deep questionnaire form below to be contacted by our matchmaker for further review.
Due to the volume of received applications, please, allow us up to 4 business days to contact you for further detailed interview.


Oksanalove.com Inc - Confidential Questionnaire

* Name (first/last):
* Address:
* City:
State:
* Zip/Postal Code:
* Country :
Do you own or rent your home?:
How Long?:
* Best Contact Phone Number:
* Best Contact Time:
* Best Contact Method:
Home Phone:
Work Phone:
Fax:
Cellular:
* E-mail:
* How did you hear about Oksanalove.com Inc?
Indicate your readiness to begin:
Please explain:
Have you experienced other services? Yes No
Please explain:
Do you travel internationally? Yes No
If Yes, How Frequently?
To Which Destinations:
* Place of birth:
* Date of birth: Month Day Year
* Gender:
* Height: Feet Inches
* Weight:
Hair Color:
Eye Color:
Education:
Describe your education:
* Occupation:
Describe your occupation:
* Income:
Select the Currency in which your income is stated:
Assets:
Employed By:
Are you self-employed?: Yes No
* How much of a financial investment are you prepared to make to find your desired companion?:
Select the currency of your financial investment:
Are you emotionally prepared for marriage?
(1=lowest, 10=highest):
Are you emotionally prepared for a committed relationship?
(1=lowest, 10=highest):
Please comment on your emotional preparedness:
Marital Status:
If you are separated, divorced,
or widowed, how long?:
Years Months
Have you been
married before?:
Yes No
If yes, how long?: Years Months
Do you have children?: Yes No
Number of Children:
Number of Children
living with you:
Please describe the sex
and ages of your children:
Would you like to have
children in the future?:
Yes No
About Yourself : I am new to the area
I am too busy to meet people
I do not meet enough quality people
I am not dating anyone seriously now
I am dating someone not compatible
I want to date various people
I desire a steady relationship
I believe in marriage
I am shy
I am very outgoing
I am active
I am very active
I am passive
I am amiable
I enjoy the company of large groups
I have a small circle of friends
I enjoy quiet evenings at home
What community activities do you participate in?:
What languages
do you speak?:
Please list any other languages you speak:
Ethnic background:
I am: Adventuresome
Ambitious
Demanding
Giving
Reliable
Sexy
Thoughtful
Emotional
Organized
Romantic
Stubborn
Devoted
Creative
Affectionate
Your Athletic Activities: Aerobics
Horseback Riding
Boating
Skiing
Cycling
Swimming
Golf
Walking
Jogging
Dancing
Outdoors
Tennis
Other
Please describe any other activities:
Do you watch sports?: Yes No
Please explain:
Describe your life goals:
You attend church or synagogue: Never
Infrequently
High Holidays
Weekly Services
Daily
Twice a week or more
Comment on your religious beliefs and their influences on your life:
Do you suffer from any medical condition?
If yes, please explain.:
About your eating habits: Meat
Fish
Vegetarian
Natural Foods
Junk Foods
Other
Do you drink alchohol: Yes No
Frequency: Seldom
Occasionally
Daily
Are you an alcoholic?: Yes No
If recovering, how long?:
Do you smoke?: Yes No
Frequency: Moderate
Occasionally
Heavily
If yes, how long?:
Have you quit smoking?: Yes No



Information About The Compatible Companion You Seek

Age: to
Comments on age:
Rate their general attractiveness:
1 (Lowest),10 (Highest)
Height: Feet Inches
Weight:
Hair Color
Eye Color
What physical qualities are you attracted to?:
Ethnic Preference:
About their athletic activities: Aerobics
Horseback Riding
Boating
Skiing
Cycling
Swimming
Golf
Walking
Jogging
Dancing
Outdoors
Tennis
Televised Sports
Other
Describe any other activities:
Their occupation: Professional
Entrepreneur
Managerial
Technical
Business Person
Self-employed
Retired
Not Important
Describe any other occupations:
Their education: High School
Junior College
Vocational
University (4 year)
Masters Degree
Ph.D
Professional Degree
Not Important
Other
Other levels of education:
Their children: No Children
Desires Children
Has Children
Not Important
Comment on children:
Their preferred annual income:
Income level comments:
Their cultural interests: Dance
Family Development
Visual Arts
Music
Current Events
Intellectual
Film
Theatre
Other cultural interests:
Their musical interests: Classical
Jazz
Country Music
Opera
Easy Listening
Popular
Folk/Ethnic
Rock
Comments on musical interests:
Views on smoking:
Views on alcohol:
What are the three most important considerations about the person you want to meet?
1.
2.
3.
* Insert the security code:


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