| I am Seeking a | Man | For | Long Term | |
| Needs Test | Not Completed | Chemistry | Not Completed | |
| Do you drink? | Socially | Do you want children? | Want children | |
| Marital Status | Single | Do you do drugs? | No | |
| Hair Color | Black | Eye Color | Other | |
| Do you have a car? | Prefer Not To Say | Do you have children? | No | |
| Longest Relationship | ||||
| Pets | No Pets | |||