Registration Form

 First Name:   Last Name:     

 P.O.B:        Street:        

 City:         State:        

 Zip:          Country:                 

 Phone Number: Fax Number:   

 Sex: Male  Female  

 Height(m):     Weight(Kg):  

 Hair color:     Eye color:  

Age:    - 20    20 - 30    30 - 40    40 - 50    50 - 60    60 +    

 Are you divorced ?  Yes   No   Number Of Children:  

 Do you have custody?  Yes   No 

 RELIGION  

  Jewish    Christian    Muslim    Buddhist    Other 

 EDUCATION  

  Bachelors     Masters       Doctorate    Other:   

 Your degree is in what area 

 Currently a student:   Yes     No 

 OCCUPATION 

 Occupation: 

 How long have you been in this occupation  (yrs) 

LIFESTYLE  

 Alcohol     Never    About once a week     3 times a week 

 Do you smoke Yes   No 

 What kind of music do you like:  

 What do you like to read:        

 Hobbies,fun and relaxation:

 

There is NO FEE TO REGISTER this form with ACQUAINTANCESHIP.
Your matches will be sent to you for the time period you indicate below, which includes a FREE TRIAL MEMBERSHIP
of One Month (if after the free trial membership you do not want to continue, E-Mail us):

One month( 4 weeks )     Three months( 12 weeks )      Six months( 24 weeks )

Your E-Mail address (required!):