www.internetkontakte.com

Application form for ladies

My Address

Last name:
First name:
Street, No:
Post / Zip code:
Town / City:
Country:
Phone number 1:
Phone number 2:
Mobile phone number:
Fax:
E-Mail:
ICQ:
Internet:

My personal details

Nationality:
Birth date:
Eye colour:
Hair colour:
Weight (kg):
Height (cm):
Body type:
Marital status:
Children:
Religion:
Education:
Occupation:

Languages spoken

German:	o none	o little	o sufficient
English:	o none	o little	o sufficient
French:	o none	o little	o sufficient
Italian:	o none	o little	o sufficient
Spanish:	o none	o little	o sufficient
Portuguese:	o none	o little	o sufficient
Other languages:

My features

Minimum 5 features:

o Trustworthy
o Patient
o Honest
o Loving
o Romantic
o Passionate
o Tidy
o Natural
o Educated
o Intellectual
o Humorous
o Proud
o Supportive
o Faithful
o Merry

o Open-minded
o Reserved
o Generous
o Optimistic
o Outgoing
o Kind
o Hard working
o Polite
o Friendly
o Ambitious
o Sensitive
o Adventurous
o Impulsive
o Fashion conscious
o Sentimental

o Active
o Balanced
o Calm
o Diplomatic
o Permissive
o High-spirited
o Spontaneous
o Elegant
o Home-loving
o Attractive
o Tender
o Flexible
o Self confident
o Curious
o Feminine

My interests

Minimum 5 interests:

o Family
o Children
o Sex
o Nature
o Sports
o Animals
o Culture
o Literature
o The Arts
o Music

o Computer
o Travelling
o Cinema
o Theater
o TV
o Cars
o Dancing
o Singing
o Socialising
o Walking

o Reading
o Craft work
o Photography
o Cooking
o Languages
o Painting
o Politics
o Gardening
o Sewing
o Fashion

Smoking and drinking behaviour

Smoking:	o Don't smoke	o Socially	o Regularly
Drinking:	o Don't drink	o Socially	o Regularly

Features of my ideal man

Minimum 5 features:

o Trustworthy
o Patient
o Honest
o Loving
o Romantic
o Passionate
o Tidy
o Natural
o Educated
o Intellectual
o Humorous
o Proud
o Supportive
o Faithful
o Merry

o Open-minded
o Reserved
o Generous
o Optimistic
o Outgoing
o Kind
o Hard working
o Polite
o Friendly
o Ambitious
o Sensitive
o Adventurous
o Impulsive
o Fashion conscious
o Sentimental

o Active
o Balanced
o Calm
o Diplomatic
o Permissive
o High-spirited
o Spontaneous
o Elegant
o Home-loving
o Attractive
o Tender
o Flexible
o Self confident
o Curious
o Musculine

Age:

Don't care

From to

Contact

You can contact me best of all by:	o Phone o E-Mail	o Mobile o ICQ	o Fax o WWW
You can contact me:	o In the morning o In the afternoon	o In the evening o On weekend
Contact me please by:	o German o English	o French o Italian	o Spanish o Portuguese
Contact me please by:	o Mothertongue