Enrolment

THE DATING AGENCY

Enrolment Form

First Names……………….......................................Surname...........………………

Address…………………………………………………………….....................................................................................

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Country………………………..

Post code ..................................

Telephone Number…………………................................E-Mail address............................................

Do you wish your Tel Number./Email address to be disclosed to members. Tel.Yes/No..Email.Yes/No..

Do you like animals...........................................................................

Your age , D.O.B and starsign…………………………………………..................................................

Occupation..........................................................................................

Physical appearance, e.g. Height, build, hair and eye colour………………………………………...............................

…................................................................................................................................................................................................

Smoker/non smoker...............Marital status...............................Children (ages).....................................

Your likes and dislikes, hobbies etc.………………………………………………………………..............

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Brief description of your ideal partner and age range.........................................................................….....

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Conditions

No introductions for anyone under the age of 18 years,The Agency or its agents will not be held responsible should long-term relationships not occur , or the outcome of any meeting or contact with anyone as a result of joining The Dating Agency . All details are accepted as being accurate and genuine although no guarantee as to their validity can be given. Please note security of Email / internet services cannot be guaranted. All information disclosed to members must be treated in the strictest confidence & must not be used for any purpose other than what it was supplied for.We reserve the right to withdraw membership from anyone we consider unsuitable.

I accept the conditions & wish to enrol with The Dating Agency and enclose my cheque/postal order for £.....................

Or.free membership only.....................

Signature..................................................................................Date................................................................

Please Print this Form and return it to The Dating Agency

2, Millstream, Ringwood, Hampshire, England. BH24 3SA Tel: +44 (0) 1425 472006

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