Dating Questionnaire

 Dating Questionnaire Form

Umpius – Politically correct – Non sexist – Non racist – Diverse version

 

 

1. Your Details: (Block capitals)

Mr/Sir/Lord/RH/Lady/Mrs/Ms/Madame:

Surname: _________________________

First name:________________________

Address:____________________________________________________

___________________________________________________________

 

(Please read all the sections carefully and tick which information best describes you)

 

2. Personal Information:

a) Nationality
□ English □ Spanish □ Other □ Swedish
b) Age:
□ Over 51 □ 41 – 50 □ 20 – 40 □ 16 -19
c) Status:
□ Married □ Divorced □ Single mother □ Single Swedish
□ Non payer □ Pensioner □ Single □ On holiday
□ Tramp □ Tagged □ Omnipotent □ Available
d) Occupation:
□ Employed □ On benefits □ Criminal □ Model
□  MP □ Odd job man □ Moderator □ Cheer leader
□ Financial advisor □ Bishop □ Loan shark □ Lap dancer
□ Mayor (ESP) □ Back stabber □ Timeshare □ Porn star
□ Developer □ Lawyer □ Real estate □ Lotto winner
□ Notary □ Mad Mulla □ Banker □ Heiress
e) Religion:
□ None
3. Education:
a) School:
□ Comprehensive □ Grammar □ University □ Private
□ Amish □ Cult □ Training camp □ Diving
□ Borstal □ Monastery □ Bash Street □ Ballet
□ Mosque □ Faith □ Prison Convent
b) Qualifications:
□ O Levels □ A Levels □ Law Degree □ Dodgy CV
□ Masonic □ GCE □ Pet passport □ under par card
□ Graduate □ Forger □ Black belt □ STI certificate
□ Driving licence □ ASBO Bull fighter □ Masseuse
4. Personality:
□ Opinionated □ Belligerent □ Aggressive □ Lecherous
□ Stupid □ Abrasive □ Argumentative □ Dumb
□ Suicidal □ Overweight □ Anorexic □ Sexy
□ Transvestite □ Swinger □ Torremolinian □ Easy
□ Happy □ Depressed □ Gold digger □ Pervert
□ Profligate □ Chatterbox □ Bunny boiler □ Nympho
5. Shopping:
□ Milletts □ Zara □ Bazaar □ Ferreteria
□ Waitrose □ Tesco □ Mercadona □ Iceland
□ Shopping Mall □ Internet □ Primark □ Sunday Market
□ Pets at home □ Zara upstairs □ Skip □ Charity shop
Do not click □ Clarks □ New York □ Morrisons (Gib)
 □ Tien 21 □ PC World □ Ebay □ Todo shop
6. Fashion:
□ Frumpy □ Haute couture □ Skimpy □ Ann Summers
□ Shell suit □ Baby clothes □ Wedding dress □ Birthday suit
□ Ben Sherman □ Football kit □ Wet T- Shirt □ Apron
□ Goth □ Boiler suit □ Burqa □ St Trinians
□ Flip Flops □ Wellingtons □ Dr Martins □ High heels
□ Bloomers □ Chastity belt □ Speedos □ Commando
 7. Appearance:
□ Chav □ Ugly □ Paper bag Curvaceous
□ Goofy □ Big nose □ False teeth □ Luscious lips
□ Tattoos □ Body jewellery □ Six pack □ Waxed legs
□ Bolt in neck □ Hunch back □ Mincy □ Hubba! Hubba!
□ Beard □ Beard on face □ Hairy □ Clean shaved
□ Green eyes □ Blue eyes □ Glass eye □ Guide dog
□ Skinny □ Slim Plump □ 38-24–36
□ Blonde wig □ Dyed Blond □ Bald □ Blonde
8. Cars:
□ Ferrari □ Hired □ Transit (White) □ Corvette C5
□ 4 x 4 □ Seat (Any) □ Stolen □ Corvette C6 ZO6
□ VW Golf □ Soap box □ Batmobile □ Corvette C6 ZR1
□ Mercedes □ Sinclair C5 □ Mobility scooter Corvette C7
9. Hobbies:  Interests:
□ Fishing □ Golf □ Sunbathing □ Washing up
□ Caravanning □ Passing wind □ Bomb making □ Cooking
□ Conkers □ Knitting □ Smoking □ Eating curry’s
□ Breaking rules □ Swimming □ Stalking □ Ironing
□ Vandal □ Shopping □ Horse racing □ Nintendo Wii
□ Train spotter □ Peeping Tom □ Swearing □ Naturist
10. Books:
 Reading:
□ Biographies □ Fiction □ Non Fiction □ Law in Spain
□ Insurgent Times □ Sunday Sport □ SUR in English □ Civil Code
□ Graffiti □ Next Catalogue □ Sporting Life □ Jamie Oliver
□ Tin Tin □ Health & Fitness □ Real ale expert □ AGM minutes
□ Most Wanted □ Closer □ Koran □ Viz
□ Umpius □ Pigeon Racer □ Karma Sutra □ Prima
11. Films & TV:
□ The Exorcist □ Al Jazeera News □ Pulp Fiction □ Costa del Crime
□ The Godfather □ The Krays □ Neighbours from Hell □ SKY News
□ All the soaps □ Top Gear □ Come dine with me □ Psycho
□ Queen’s speech □ Hang em High □ Silence of the Lambs □ Team America
□ The Living Dead □ Wife Swap □ Catch 22 □ Paradise Lost
□ Cruising □ Wild Bunch □ Sexy Beast □ Home Videos
12. Gastronomy:
□ Restaurant □ Café □ Dustbin □ Fast food
□ Chip shop □ Barbecue □ Al a Carté □ Burger van
□ Pie & Mash □ Chum □ Tapas □ Full English
□ Wine □ Real ale □ Aqua sin gas Hot mumbas
□ Spirits □ Cocktails □ Mentholated spirits □ Cloudy cider
□ Cerveza □ Tinto verano □ Café con leche □ Feliz hora
13. Weblogs:
□ Advertising □ Recipes □ How to paint □ Daily life
□ Train timetable □ Se vende □ Cut & paste news □ Hijack threads
□ Football news □ Egg boiling □ Posh or Jordan □ Comment
□ Basura hoy □ Torture a promoter □ Financial advice □ Rant
14. Lifestyle:
□ Playground □ Hotel Sink estate □ Residence
□ Gossip □ Apathetic □ Moaner □ Guardian
□ Parasite □ Do as you likey □ NIMBY □ Respectful
□ Disgruntled □ Vengeful □ Vandal □ Coexistence
□ Burden □ Noise level 120db □ Not my kids □ “Silence! I kill you”
15. Politics:
□ Liberal □ BNP □ Conservative □ Not old enough
□ Labour □ ETA □ PP □ Umpius
Have you ever been interviewed by MI5 or MI6?  Y/N
Are you offended by adult humour?       Y/N
Do you hang back when it is your round?         Y/N
Do you believe the Spanish justice system works? Y/N
Do you enjoy the TV format Benidorm?    Y/N
Did you enjoy the TV format Eldorado?  Y/N
Do you believe Los Barcos is a real Andalucian village?   Y/N
Do you reserve sun bed’s during the night? Y/N
Do you drive without flip flops?          Y/N
Do you like to go to bed early and discuss fishing for carp?   Y/N
Do you adore fat geezers with a beer gut?  Y/N

 

I hereby confirm that I read the above and agree to the terms and conditions set out below:

None

Disclaimer for any future libellous actions. This profile information may be provided on forums or for marketing purposes to third parties.

 

Date:      /       / 2012      Valid  for 500 years

 

Signed:……………………………………………………………………………………..

 

As the questionnaire is very informative please fill in your telephone number where indicated:

 

Tel:__________________________  (Please send personal photograph)

 

A strict privacy policy is observed for all the information provided by you.

 

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