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Part 1: YOUR PERSONAL DETAILS
This section of the questionnaire deals with your own characteristics. Please read each question carefully and select at least one option in each section where applicable. To ensure a good match and to avoid disappointment you should answer the questions accurately.

Membership is available to people between the ages of 30 to 70, are you within this age range?
yes       no

Do you reside in the following areas: Northants, Beds, Bucks, Herts, South Leics or East Warks?
yes       no

If no, are you willing to travel further to see members within the above counties?
yes       no

My sex is:  m f

My height is  

My weight is

My d.o.b. is (dd/mm/yy)


My occupation is


Please tick one or more of the following occupational characteristics
Senior/intermediate professional
Junior professional
Skilled
Semi / unskilled, on state benefit
Director
Manager
Supervisor
Self-Employed

This part of the questionnaire deals with your own characteristics
Please select one option from each of the following:

Marital Status:


Physical Type:


Appearance:


Complexion Typical Of:


Education:


Religion:


Political Attitudes:


Smoking:


Drinking:


Do you have your own transport?


I have: children under 16 living at home

I live:

Star sign:

Part 2: YOUR PERSONALITY AND INTERESTS Please select as appropriate for each of the following
Personality:


I am usually placid
I am cheerful
I am nervous
I talk to people
I make decisions
I express emotions
I dislike arguments
I love to stay at home
I am shy
I am patient
I am self-confident
I am often moody
I am romantic
I am affectionate
I prefer to listen
I enjoy going out
I am outgoing
I am generous
I am often pessimistic
I am a happy person
I am sentimental
I am ambitious
I hate to be criticised
I enjoy making friends
Interests:


Pop Music
Jazz
Theatre
Cinema
Eating Out
Dinner Parties
Chess/Cards
Collecting
Swimming
Golf
Cycling
Gardening
Classical Music
Folk Music
Concerts
Dancing
Pubs / Wine Bars
Reading
Cooking
Motoring
Sailing
Angling
Athletics
Animals
Opera
Country & Western
Ballet
Parties
Clubs & Discos
Television
Carpentry
Spectator Sports
Tennis / Badminton
Horse Riding
Camping / Hiking
Photography
Personal mini-profile facility
Add that personal touch to your introduction.
You may leave this part blank, and send it on later if you prefer
If you wish to send it on later, please tick here

Hint: Write about your occupation, likes and not too many dislikes, what you are looking for in a relationship, your appearance (ie: hair colour, eye colour etc), your lifestyle and expand on any special interests.
PART 3: THE TYPE OF PERSON YOU WOULD LIKE TO MEET
This section is for you to specify what characteristics you particularly like in a person, for guidance only.
Please select on option from each of the following
Marital Status:


Physical Type:


Appearance:


Complexion Typical Of:


Education:


Religion:


I would like to meet people between the age of
and

I would like to meet people between the height of
and
Political Attitudes:


Smoking:


Drinking:


If you wish to give a short message to you introduction (e.g. times to ring you, etc) please write it here, else leave blank.




Sundry
Is there any reason why you might not be suitable for membership?
(i.e. criminal record / health problems, etc)
yes     no

If you answered 'yes' please explain further here

Finally, to end the questionnaire, you can use this box to add more about yourself or your ideal partner if you wish.
PART 4: MY APPLICATION
Your name, address and telephone number:
For security reasons, your address and surname are not given out to other members


Mr Mrs Ms Miss
Surname:
First Name:

Address:
Street1
Street2
District
Town   
County
Postcode

Telephone:

Mobile:

Email:

How would you like members to contact you?
please select at least one option
Telephone (landline):
Mobile:
Letter (via our office with a box number) :

In addition to one of the above you may also have your email address circulated to selected members.
Would you like to do this?
Yes No


Please read these conditions of membership, and check the "I agree" box, below. Use the scrollbar on the right to scroll though conditions of membership
I Agree:       I Do Not Agree:
(applications cannot be accepted without your agreement to the Conditions of Membership)


Payment Details:
For 12 months membership from acceptance of your application.

Please tick your choice of register:

I wish to apply for membership of "THE FRIENDSHIP CLUB" £69 plus £6 monthly standing order
(Sterling standard level) FREE further introductions


I wish to apply for membership of "TOP PEOPLE" £99 plus £9 monthly standing order
(Gold professional level) FREE further introductions

When we receive your application and cheque we will send you a standing order form.



FREE offer
to all 'TOP PEOPLE' professional applicants only!
The Friendship Club register (for all persons) has many professional members too
If you wish, we can also introduce you to these people free of charge.
Please Click: Yes





DATAMATE-UK will confirm your application by return e-mail within two days.
Please note that introductions cannot be made until payment has been received

Thankyou for taking the time to fill out this form, if you have any queries, you can email us at info@datamateuk.com .


© 2006 Freetimers & Datamate-UK! Dating Northamptonshire


Dating Northamptonshire, Buckinghamshire, Bedfordshire, Hertfordshire, Leicestershire & Warwickshire