Any lady can be placed on our web site!

Please complete the information requested on this form. This will enable us to help you to receive maximum results for your Personal Ad. You may send this information by regular mail along with your best quality photos ( the more, the better) to the address at the bottom of this form.

Name:
Address:

City:
State:
Zip Code:
Country:
e-mail address (optional - if you prefer to receive correspondence by regular mail):

Age:
Nationality:
Height (inches or mts.):
Weight (pounds or kilos):
Color Eyes:
Color Hair:
Marital Status (check one): single: divorced: widowed:
Children: (how many)
Education Level (check one): high school university graduate
Profession:
Languages (check): English Spanish German French Italian Other
Hobbies:


Personalities:


Smoke: Drink:
Religious Preference:

Your space to write interesting comments about yourself and to describe the type of
person you would like to meet (be creative for good responses).

Full this form and send to Ukraine, 270021, Odessa st.Novoselskogo 60-3 "Ballade of Love"