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| Desired Relationship: Check all that apply, or leave completely blank for "Any" |
| | Pen Pals Friendship | Short-term Dating Long-term Dating | Marriage Sex only |
| Race: Check all that apply, or leave completely blank for "Any" |
| | White Black Hispanic | East Indian Middle Eastern Asian | Native Mixed Other |
| Age: Check all that apply, or leave completely blank for "Any" |
| | 19 to 24 25 to 29 30 to 34 35 to 39 | 40 to 44 45 to 49 50 to 54 55 to 59 | 60 to 64 65 to 69 70 plus |
| Weight: Check all that apply, or leave completely blank for "Any" |
| | less than 100 lbs 100 to 114 115 to 129 130 to 144 | 145 to 159 160 to 174 175 to 189 190 to 204 | 205 to 220 221 to 249 250 to 999 |
| Height: Check all that apply, or leave completely blank for "Any" |
| | Under 4ft 6in 4ft 6in to 4ft 9in 4ft 9in to 4ft 11in 5ft to 5ft 2in | 5ft 3in to 5ft 5in 5ft 6in to 5ft 8in 5ft 9in to 5ft 11in | 6ft t o 6ft 2in 6ft 3in to 6ft 5in Over 6ft 6in |
| Smoke: Check all that apply, or leave completely blank for "Any" |
| | Non Smoker Social Smoker | Smoker | Cigar/Pipe Smoker |
| Body Style: Check all that apply, or leave completely blank for "Any" |
| | Thin Athletic Average | Fit Thick A Few Extra | Large Voluptuous |
| Drink: Check all that apply, or leave completely blank for "Any" |
| | Abstainer | Social Drinker | Drinker |
| Have Children?: Check all that apply, or leave completely blank for "Any" |
| | No Children Young or Infant | Preteen | Teenage or Older |
| Religion: Check all that apply, or leave completely blank for "Any" |
| | Agnostic Alternative Atheist Buddish/Taoist | Catholic Hindu Islamic Jewish | Protestant Christian Spiritual |
| Marital Status: Check all that apply, or leave completely blank for "Any" |
| | Single Living Together Happily Married | Separated Divorced Widowed | Unhappily Married Married but Looking |
| Zodiac Sign: Check all that apply, or leave completely blank for "Any" |
| | Aries Taurus Gemini Cancer Leo | Virgo Libra Scorpio Sagittarius | Capricorn Aquarius Pices Who Cares |
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| | Height Weight | Have Kids Age | Race Smoker |