How did you find out about us?
Your personal information:
- First name:
- Last name:
- Nationality:
- Date of birth (mm/dd/yyyy):
- Birthplace (city, state or region, country):
- Height:
- Weight:
- Hair color:
- Eye color:
Your ancestral background:
- Father's side:
- Mother's side:
Your Contact Information:
home address:
- Street/city/state/country/zipcode:
- Phone number:
- Fax number:
- E-mail address:
Alternate address, if any:
- Street/city/state/country/zipcode:
- Phone number:
- Fax number:
What is your marital status (never married, divorced, widower)?
- If you have been divorced, please tell us how many times you have been
divorced: times
- If you have been divorced, please provide a brief explanation of the reaso for each of your divorces and also please tell us the nationality of each of your ex-wives:
- First divorce:
- Second divorce:
- Third divorce:
How many children do you have? ____________children
- If you have children, how old are they, are they living with you or are you otherwise supporting them?
- Do you want additional children?
Do you want children?
How would you describe your health?
Do you smoke?
How much alcohol do you consume (none, moderate, heavy)?
Japanese language ability?
List all of the languages that you speak, including your mother tongue:
Career:
- Please tell us your previous job title:
- Please describe your previous job:
- How many years were you at your previous occupation? years
- Please tell us your present job title:
- Please describe your present job:
- How many years have you been in your present occupation? years
- What is your gross annual income:
- What is your approximate net worth:
(To determine your net worth, first add up all of your assets, including
savings, investments and the fair market value of any property, housing and/or vehicles you own. Next, add up all of your debts, which will include the amounts remaining on all loans you have for things such as property, home, education and vehicles. Finally, subtract your total debt from your total assets to calculate your net worth.)
Do you prefer that your spouse continue to work after marriage?
Education:
- What is the highest degree you have attained?
- In what year did you attain your highest degree?
- Please tell us the name of the college/university/institution from which you attained your highest degree:
- Please tell us the city and country where the college/university/institution
from which you attained your highest degree is located:
- If you attended a university or college, what was your major?
What hobbies, interests and special skills do you have?
What countries have you visited?
Do you hold any religious beliefs?
If you hold any religious beliefs, please tell us the name of the religion as
well as the specific denomination within the religion, if any:
How would you describe your personality?
What is most important to you?
Please tell us some desirable qualities you seek in a mate:
Why do you wish to meet a Japanese Lady?
What are your hopes and plans for the future?
Is there anything about you which your future spouse would want to know before becoming involved with you?
Dandies International Matchmaking Services
Marriage Agency Dandies International (DI)
Win Aoyama 1419, 2-2-15 Minami-Aoyama
Minato-Ku, Tokyo 107-0062 Japan
Tel: +81-3-3470-2012 E-mail: di_application@dandies.to
:japanese women seeking western men:
correspondence, possibly leading to marriage
