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I am new to the area I am dating someone who has different goals than me I am not dating anyone seriously I would like to have children I would like to get married I have not been meeting the right people I am too busy to make new contacts I would like to date many different people I am already a parent
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*First Name	*Last Name
*City	*Zip
*Evening Phone    --	*Daytime Phone --
*Email Address	*Age (Must be 20+)  Select Age 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70
*Gender    Select Gender Male Female	*Height Select Height Under 5 ft 5 ft - 5 ft 2 in 5 ft 2 in - 5 ft 4 in 5 ft 4 in - 5 ft 6 in 5 ft 6 in - 5 ft 8 in 5 ft 8 in - 5 ft 10 in 5 ft 10 in - 6 ft 6 ft - 6 ft 2 in 6 ft 2 in - 6 ft 4 in Over 6 ft 4 in
*Weight    Select Weight Less than 100 lbs 100 -115 lbs 116 - 125 lbs 126 - 135 lbs 136 - 150 lbs 151 - 175 lbs 176 - 200 lbs 201 - 250 lbs 250 lbs and up	*Race Select Race Latino/Hispanic White/Caucasian Asian Islander Black Middle Eastern Native American East Indian Mixed
*Current Income(Must be 24k+) 25k to 35k 51k to 100k 36k to 50k >100k	*What is the best time for us to contact you? Select Time Morning at Home Morning at Work Afternoon at Home Afternoon at Work Evening at Home Late Evening at Home
*Your Occupation?    Select Occupation Accounting Actuarial Administrative Advertising Aerospace Agriculture Apparel Architecture Arts Automotive Banking Bilingual Biotech Computing Construction Consulting Design Direct Marketing Education Engineering Entrepreneur Environmental Finance Forestry Franchising Geology Nonprofit Graphics Health Hospitality Human Resource Insurance International Law Librarians Logistics Management Marketing Metals Mining Multimedia Oil & Gas Operations Packaging Pharmaceutical Plastics Printing Public Relations Publishing/Media Pulp & Paper Purchasing Quality Control Real Estate Religious Retail Sales Scientific Self Employed Telecom Trade Shows Technician Transport	Primary Social Goal: To date more successfully To have a steady relationship Marriage
Please tell us a little about yourself:
*Marital Status:     Select Never Married Divorced Separated Widowed	*Education Level : Select High School Some College Assoc. Degree Technical School Bachelors Degree Masters Degree Ph.D Other
*Typical Work Schedule :     Select 9:00 to 5:00 Afternoon through evening hour Prefer not to say My time is my own The late shift Always Changing
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