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Sign up progress

1. Personal Details
This information is for our records only

* denotes essential information
Sex:*
Title:*
First  Name:*
Surname:*
Address 1:*
Address 2:
Town/City:*
County:*
Postcode:*
Country:*
Home Telephone Number:* incl. Code
E-mail Address:*
I prefer to be known as: 




2. Your Profile
This information will be used to create your portfolio
Your Height:*
Your Build:*
Your Eye Colour:*
Your Hair Colour:*
Ethnic Origin*
Your Looks:*
Your Education:*
Occupation:*
Your Religion:*
Your Marital Status:*
Your Date of Birth:* / / dd/mm/yyyy
Your Smoking Habits:*
Your Political Views:*
How Many Children Do You Have?:*



3. Your Personality
This information will be used to create your portfolio

How would you describe yourself?

1=doesn't describe me at all, 5=describes me perfectly.

 
Not at all
Not Sure
Perfectly
Extrovert:
Introvert:
Independent:
Intelligent:
Confident:
Practical:
Good sense of Humour:
Reserved:
Approachable:
Shy:
Affectionate:
Conventional:
Fashionable:
Cautious:



4.Your Interests
This information will be used to create your portfolio

How interested are you in the following?  i.e. do you currently spend time doing these activities?

1=not interested at all, 5=very interested.

Not at all

Not Sure

Very

Reading:

Motor sport:

Art/Architecture:

Music:

Tennis:

Football:

Golf:

Rugby:

Walking:

Travel (inc foreign holidays):

Dancing (any):

Dog/Horse Racing:

Bowling:

Photography:

Cooking:

Gardening:

Keep Fit/Gym:

Horse Riding:

Skiing:

Swimming:

Cycling:

Sailing:

Watching Sport:



5. What type of relationship are you looking for?
This information will be used to create your portfolio

I am a.:

What type of relationship are you looking for?



6. I enjoy spending my time...
This information will be used to create your portfolio

1=I don't enjoy this, 5=I enjoy this enormously.

 

Don't enjoy

Enjoy
Going out for a meal:
Socialising with friends:
Going to the cinema:
Going to a night club/disco:
Going to the theatre:
Having a quiet night in:
Going to a concert:
Going for a drink (pub/bar):
Going to the opera or ballet:
Going to a party:





7. Membership Details
Choose a username:
Password:
Retype Password:
 

Where did you hear about Platinum Select?

I agree to the Terms and Conditions set out and consent to Platinum Select using the data submitted to provide me with details of people who match my requirements.

 I agree

Remember once your portfolio is complete you will be able to amend your details.

 
 
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