Join Membership Form of DARINA Marriage Agency and International Club, Odessa, Ukraine

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Questionnaire for DARINA AD

Full Name Your full address

E-mail URL

Age Height Weight Eyes:

Hair: Figure: Smoking: No Yes

Drinking: Martial Status:

Children: . Education:

Occupation: Please specify

Ethnic group: Specify Religion:

Features of Character and Interests

Who are you looking for

Age: Martial Status: Eyes:

Hair:

Build: Smoking Drinking:

Children: Education:

Occupation:

Specific wishes for who you're looking for:

Some more about you

Lady
Your Favorite Color:

Your Favorite Flowers:

Your Favorite Perfume:

Gift of Your Dream:

Car of Your Dream:

Journey of Your Dream:

Words You Wish To Hear
From Your Beloved Man :

Man
Your Favorite Color:

What Attracts You
Most in a Woman?

Your Favorite Style in Clothes:

Your Favorite Car:

What Kind of Surprise
Would You Like to Get
From Your Beloved Lady?

Where Would You Invite
Your Lady For the First Date?

How Can You Describe
Yourself in One Sentence?

What Words Would You Like
to Hear From Your Beloved Lady?

What Would You Do
to Surprise Your Lady?

What Attracts You
Most in Family Life?