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Spin Dating Questionnaire
All information you submit will be kept strictly confidential.
It must be true and updated at the time of submitting.
          First name:          Last name:
       Number & street Apartment City
Province       Postal Code
       Home phone   Work phone     Email
       Date of birth                   Marital status
       How did you hear about us?              

       A. Please mark the age group you are interested in (you may mark more than one group):
20-25     25-30     30-35     35-40     40-45     45-50     50-55     55-60
      B. Basic information about yourself:
  • Gender Height Weight  
 Body build:  Slim    Average   Overweight
  • Level of education:       Occupation:
  • Do you have children?        How old?        Do you want (more) kids?
  • Your interests and hobbies:
  • Do you smoke?    Do you drink?    Do you have pets?
  • What is your language of preference?   English French Other
  •  Are you interested in marriage?    Long term relationship?    Casual relationship?
       C. Basic information about the person you are seeking (you may mark: N/A where applicable):

        1. Looks (body build, height etc.):

        2. Do you mind if they have children from a previous marriage?

        3. Level of education: Occupation:

        4. Do you have preferences for the other person's religion? Their ethnicity:

        5. Their interests and hobbies:

        6. Do you mind if they smoke?  yes   no     Drink?  yes no   Have pets? yes no

List the three most important items to you in Part C (1-6).    For example: 1, 3, 6


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