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| Ваш e-mail |
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| The request is convincing to observe rules at filling the questionnaire. The questionnaire should not be illiterate, illegal, obscene. In the text of the unit be short about itself does not owe numbers of telephones, home addresses. |
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| Be attentive at the indication e-mail of the address, because on this address the letter for acknowledgement (confirmation) of the questionnaire will be sent to you. |
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| After sending the questionnaire from our site, the request to duplicate sending by usual mail on our post address, thus is reached (achieved) high reliability of the placed information. |
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| The edition of a site reserves the right to itself to give up in accommodation of the questionnaire, if will find for this purpose the powerful reasons. |
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| The request to fill in all sections of the questionnaire! |
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| You the woman: |
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| You the man: |
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| Want to get acquainted: |
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| The purpose of acquaintance: |
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| Your surname: |
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| Your name: |
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| Yours e-mail: |
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| Repeat yours e-mail: |
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| At you is ICQ? If yes, specify: |
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| You have home site? If yes that specify: |
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| Your city: |
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| Your country: |
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| Date of birth: |
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| Mark of the zodiac: |
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| Your age: |
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| Your growth: |
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| Your weight: |
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| Formation education: |
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| Creed: |
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| Trade: |
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| Children: |
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| Knowledge of foreign languages: |
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| Shortly about itself (up to 1000 symbols): |
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| Wish to the partner (up to 100 symbols): |
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| The following sections are necessary for service usage. To disclosure are not subject. |
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| Surname, name, patronymic: |
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| The complete post contact OR home address: |
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| I ask to send on my post address the printed version of the catalogue '' of Kharkov Ukraine - World ''. |
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| The questionnaire with photos in a format JPG, JPEG, size of files no more than 100 К are accepted only, the photos should be colour on a light background. |
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