S4S - Information Sheet
(send via email to singles4singles@excite.com)
Name:
_______________________________________ Date_________
Address: ________________________City: _______State: _____
Zip: __________
Home Phone: ____________________ Work Phone: _________________________
Cell Phone: _________________ Best Time To Be Reached: ___________________
E-Mail Address: ___________________
Age:
_________ I prefer to date approximate age range: ____ to _______
Height:__________________ Marital Status (# of children)__________
Occupation: __________________________________
Educational Background: ____________________________________________________ of Affiliated Shul/Synagogue: ______________________________________________
Hashkafic Orientation (Please provide brief
description): ___________________________________________________________________________
Interests/Activities That I Enjoy:
________________________________________________________________
Qualities That I Am Seeking In A Mate:
______________________________________________________________________
References (Please include telephone
numbers): _____________________________________________________________________
Additional Comments and photo: