To e-mail this questionnaire, please use the links on the right side of the page.
For snail mail, send to:
Marilyn the Matchmaker, PO Box 51233, Eugene, OR 97405
Questionnaire
Name:
Address:
Contact Phone:
Email address:
How did you hear about Marilyn the Matchmaker?
DOB: Astrological sign:
Where did you grow up?
Height: Weight:
Education: Is education level important to you in a partner?
Current Occupation:
Former types of work:
Religious/spiritual beliefs: Is this important to you in a partner?
Political affiliation: Is this important to you in a partner?
Have you been married or in long-term relationships?
Please give a brief synopsis of your relationships to date:
Do you have children? Ages:
Do you want more children?
Are you OK with a partner who has children?
Age Range of Potential Partner:
What are you looking for in a potential mate?
Do you want to be married or is a long-term relationship/life-partner OK?
How would you describe your personality?
What are your hobbies, activities and interests? How do you spend your leisure time?
Are you physically active? Is this important to you in a mate?
Do you smoke? Drink?
Do you have pets?
Your 3 top interests:
Describe yourself in 3 words:
List your 6 "Must Haves" and 6 "Deal Breakers" in a relationship:
Must Haves:
1.
2.
3.
4.
5.
6.
Deal Breakers:
1.
2.
3.
4.
5.
6.