Ladies Application

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Fields marked with * are required to be filled in.

Your personal information and data:

1. First Name: *
2. Last name:  *
3. Date of birth: 
*  
4. Mailing address:
Street Address *
City *
Region
Postal Code *
Country *
5. Telephones: 
Home Work
 Mobile   for ex: 7 095 123 4567
Never call me with out my permission.
Call me with an interpreter only.
6. Fax: 
7. E-mail:  1st Email
2nd Email
3rd Email
8. Marital status: never married
divorced
widow
9. Height: *
10. Weight:  *
11. Hair color: *
12. Eye color:  *
13. Education: 
14. Occupation: 
15. Foreign languages: If yes, specify language
1.
2.
3. Other Language
16. Children: Yes
No

If yes, specify their age and sex:
1. y.o.
2. y.o.
3. y.o.
male female
male female
male female
17. Do you smoke: Yes
No
18. Do you drink: Yes
No
19.Religion:
20. Do you want to have children in marriage: Yes
No
21. Your Interests and hobbies:
22. Your message to men:
(tell about yourself and describe your character
  Your preferences for a partner
1. Age:  years old to Does not matter
Include your desires about his race, country of residence, religion, previous marital status, does he have children, height, weight, smoking, drinking, hair color, eye color
level of education, occupation and his interests and hobbies.
 
By submitting this form you are agreeing to the following:

I hereby release and hold harmless and forever discharge ASL Corp. and Match, Inc. from any and all liabilities, civil, criminal, or otherwise, under any and all laws, arising from:
 
1. My consent to ASL Corp. and Match, Inc. to permit and facilitate any communication and meeting between myself and male website users.


2. My consent to the release of my personal contact by ASL Corp. and Match, Inc. to male clients who request this information.


3. My access, viewing and use of any persons background information, which I agree is private and confidential only as to me for the sole purpose of my consent given to ASL Corp. and Match, Inc.


4. Any future conduct by me or other website users in any and all relationships and communications.
 
 
 

Email Your Photos to: Odessa@aslcorp.us or Moscow@aslcorp.us