NAME

ADDRESS

CITY

FIRST ORDER ADMINISTRATIVE AREA

STATE/PROVINCE/TERRITORY/REGION

ZIPCODE/POSTALCODE

COUNTRY

E-MAIL

EXCLUDING NAME, COUNTRY, AND IN MOST CASES FIRST ORDER ADMINISTRATIVE AREA:
THE ABOVE INFORMATION WILL NOT BE  ON THIS WEB SIT
WITHOUT WRITTEN AUTHORIZATION! 

GENERAL:

Gender Male Female Birth Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Maritial Status Single/never married Married Widowed Divorced Separated Children Have no child/children Have child/children

EDUCATION:

Education Elementary/Primary Secondary/High Trade school Some college/university Degree college Post graduate work

OCCUPATION:

Occupation Unskilled Skilled Commercial Clerical Craftsworker Engineer Farmer/rancher Homemaker Independent/self Machine operator Professional Retired Student Sales Technical Other

HOBBIES & INTERESTS (3 choices):

Hobbies & Interests Animals Antiques Art Astrology Banknotes Books Cycling Cinema/Movies Coins Computers Concerts Cooking Correspondence Culture Dancing Driving Ecology Economy Folklore Games Genealogy Gift Exchange Homelife Languages Literature/Poetry Magazines Match box/labels/folders Modeling Music-collecting Music-listening Music-playing/singing Nature Needlework Newspapers Painting/drawing Pen friends People Philosophy Photography Politics Psychology Reading Religion Scale modeling Science Souvenirs Space Spoons Sports-observation Sports-participation Stamps Theater Traveling TV Videos Viewcards/postcards Wildlife World affairs Writing Hobbies & Interests Animals Antiques Art Astrology Banknotes Books Cycling Cinema/Movies Coins Computers Concerts Cooking Correspondence Culture Dancing Driving Ecology Economy Folklore Games Genealogy Gift Exchange Homelife Languages Literature/Poetry Magazines Match box/labels/folders Modeling Music-collecting Music-listening Music-playing/singing Nature Needlework Newspapers Painting/drawing Pen friends People Philosophy Photography Politics Psychology Reading Religion Scale modeling Science Souvenirs Space Spoons Sports-observation Sports-participation Stamps Theater Traveling TV Videos Viewcards/postcards Wildlife World affairs Writing Hobbies & Interests Animals Antiques Art Astrology Banknotes Books Cycling Cinema/Movies Coins Computers Concerts Cooking Correspondence Culture Dancing Driving Ecology Economy Folklore Games Genealogy Gift Exchange Homelife Languages Literature/Poetry Magazines Match box/labels/folders Modeling Music-collecting Music-listening Music-playing/singing Nature Needlework Newspapers Painting/drawing Pen friends People Philosophy Photography Politics Psychology Reading Religion Scale modeling Science Souvenirs Space Spoons Sports-observation Sports-participation Stamps Theater Traveling TV Videos Viewcards/postcards Wildlife World affairs Writing

OTHER:

Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered

Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered

Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered

Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered Other Help offered to travelers Hospitality offered Meeting Marriage Immigration Non-smoker Non-drinker Non-drug user Broad-minded Send photo All letters answered

LANGUAGES (First & second language):

First language Arabic Cantonese Mandarin Danish English Esperanto French German Hebrew Italian Japanese Portuguese Russian Spanish Second language Arabic Cantonese Mandarin Danish English Esperanto French German Hebrew Italian Japanese Portuguese Russian Spanish

Other languages, hobbies, interests or information you wish included with your introduction may be typed in the box below:  CCC-C and/or CCCC may edit ads for space, content or whatever CCC-C and/or CCCC deems necessary.  CCC-C and or CCCC has no control or responsibility for members' responses, lack of, nor content of correspondence.   CCC-C and/or CCCC is not responsible for any actions resulting from its membership or from releasing your name, bio, mailing and/or e-mail address, photo, or any other information to others.
Please use your return/enter key while typing information Thank You.

          THANK YOU!