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* 1. Please enter your contact information.

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* 2. Where is your hometown?

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* 3. Do you own your own home?

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* 4. What is your gender?

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* 5. What is your sexual orientation?

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* 6. When is your birthday? What time were you born on this day? If you do not know your birth time, please put 12:00AM.

Date
Time

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* 7. What color hair do you have?

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* 8. What color eyes do you have?

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* 9. What is your religious affiliation?

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* 10. Have you ever served in the military?

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* 11. How tall are you?

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* 12. Are you a US citizen?

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* 13. If you are NOT a US citizen, please explain your nationality and current immigration status. (Type N/A if you are a US citizen.)

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* 14. Do you speak any other languages besides English?

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* 15. What is your ethnicity?

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* 16. What is your highest education level?

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* 17. How many children do you have?

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* 18. If you don't have children, do you want them in the future?

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* 19. If you have children, do they live with you?

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* 20. Is it important to you for your potential partner to want children in the future?

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* 21. Do you have any other family members or roommates that live with you?

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* 22. Have you been married before?

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* 23. Are you a widower?

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* 24. What type of relationship are you looking for?

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* 25. Are you looking for true love?

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* 26. How long have you been single for?

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* 27. How many hours do you work a week?

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* 28. What do you do for a living?

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* 29. What has been your longest relationship?

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* 30. When did your last relationship end?

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* 31. What are your goals for the future when it comes to romance/finding that special person?

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* 32. Do you travel for work?

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* 33. Would you date someone who traveled for work?

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* 34. Would you date someone who worked multiple weeks at a time? For instance, someone who works offshore only home 1-2 weeks per month?

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* 35. Would you date someone who works overnight i.e. 5:00 pm - 5:00 am?

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* 36. Are you open to dating outside of your race?

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* 37. Are you open to dating outside of your religion?

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* 38. Is height important to you when you are trying to find a partner? If so, what is your preferred height range?

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* 39. What body type are you attracted to?

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* 40. What is your body type?

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* 41. What is your love language?

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* 42. How long have you been single for?

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* 43. Do you have any siblings? If so, how many?

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* 44. Do you do any volunteer work or have you ever done volunteer work?

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* 45. What are your hobbies?

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* 46. What types of music do you listen to?

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* 47. What is your astrological sign?

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* 48. Do you have any pets?

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* 49. How important is sex to you in a relationship? Explain.

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* 50. What are your views when it comes to being sexually active with a potential partner?

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* 51. Do you like to be more dominate in your relationships or submissive?

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* 52. Are you looking for a traditional relationship with traditional roles or a relationship that is not too traditional? Explain and be as specific as possible.

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* 53. Would you be comfortable marrying someone who was previously married?

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* 54. Are your parents still together or divorced?

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* 55. Do you have any tattoos?

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* 56. Are you against being matched with anyone that has tattoos or piercings?

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* 57. Are you a smoker? If so, how often?

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* 58. Are you against being matched with a smoker?

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* 59. Are you willing to attend speed dating events?

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* 60. Are you available for events during the week?

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* 61. Is it important to you that someone have the same hobbies as you?

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* 62. Do you drink? If so, how often?

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* 63. Would your previous partners describe you as someone who is affectionate?

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* 64. What is your political party affiliation?

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* 65. Is it important to you that someone support the same political party as you?

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* 66. Please list an emergency contact with their name and phone number.

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* 67. Upload face photo

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 68. Upload full body photo. NO NUDES!

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 69. When are you applying for the PURE membership?

Date
Time

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* 70. By submitting the PURE Compatibility Questionnaire, you are agreeing to the PURE Terms and Conditions.

Terms and Conditions

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