This application is designed to provide us with some preliminary information about you and the type of person you would like to meet. An Options representative will typically call you within 24 hours to answer your questions and schedule your telephone consultation. Options respects and is committed to your privacy. All information that you provide will be kept in STRICT CONFIDENCE and will not be shared with any other party or mailing list. Please take a few moments and tell us about yourself and the person you'd like to meet.


First Name:*

Last Name:

Address:

City:

State:

 
Zip Code:

Home Phone Number:*

Work Phone Number:

Cell Phone Number:
Email:

 
Occupation:

How Long?:


 
Tell Us About the Person You'd Like to Meet
 
 
Age:
From to Does not matter
 
Smoke:
Yes
No
Does not matter
Appearance:
Very attractive
Attractive
Average
Does not matter
 
Women:
Femme
Soft butch
Butch
Does not matter
Men:
Very masculine
Fairly masculine
Does not matter
 

Athletic Interest:
Very active
Active
Occasionally
Does not matter
Cultural Interests:
Theater
Dance
Music
Visual Arts
Film
Other
 
 
Education:
High School
Some college
Degree
Advanced degree
Body Type:
Small frame
Medium frame
Large frame
Doesn't matter
 
Other Qualities:
 

 
Tell Us About Yourself
 
 
My Age:*
My Sex:
Male
Female
Are You Planning to Move in the Next Six Months?
Yes, where?
No
 
My Primary Social Goal is:
Casual Dating
Long-Term Relationship
Formal Domestic Partnership
My Relationship Status is:
Single
Divorced
Formerly partnered
 
My Social Situation is as Follows:
I am new to this area
I am too busy to look for someone
I do not meet enough quality people
Not dating anyone I would consider for a long term relationship
Dating someone who does not want what I want in a relationship
I have not been dating
 
My Annual Income is:
Under $15,000
$15,000 to $25,000
$25,000 to $35,000
$35,000 to $50,000
$50,000 to $75,000
$75,000 to $100,000
Over $100,000

Education:
High School
Some college
Degree
Advanced degree

 
The Best Time for Options to Reach Me is:
 
What Encouraged You to Fill Out This Survey?:
 

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