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1. The last four digits of your cellphone number: ___________
2. The last four digits of your Social Security number: __________
3. What was your gender at birth? _______ Male ______ Female
4. Are you heterosexually, instead of homosexually, oriented? ______ Yes ______ No
5. What is your birth year? ________
6. What is your ethnicity: _________ Caucasian (White) ________ Negroid ________ Asian _______ Combo
7. What is your height: ________ less than 5' _______ 5' to 5'9" _______ over 5'9" ______ well over 5'9"
8. What is your weight? __ under 100 lbs __ 100 to 135 lbs __ 136 to 160lbs __ 156 to 180 lbs __ over 180 lbs ____ over 230 lbs
9. What is your eye color? ____ Blue or Blue/Grey ____ Brown _____ Dark Brown _____ Green/Yellow/Grey
10. What is your religion? _______ Non-Baptist Liturgical Protestant _____ Baptist Protestant ________ Non-Baptist Non-Liturgical Protestant ________ Catholic _______ Conservative or Orthodox Jew ________ Mormon _______ Jehovah's Witness _________ Islamic _______ Buddhist ________ Hindu ________ Russian Orthodox _______ Greek Orthodox ________ Other (Specify: _____________________)
11. How often do you attend church, synagogue, or temple? _______ At least once a week ________ Several times a year _______ Twice a year, or very seldom ________ I am a totally-surrendered-to-Christ Christian who believes the redemptive gospel of my justifying atonement-against-my-sins-Savior Jesus as Lord and who must perfectly obey all the moral Law of God 24/7
12. What is your heterosexual marital status: ________ never-been-married ______ engaged _______ boyfriend or girlfriend sexual relationship _______ legally married _______ common-law marriage or concubine ________ mistress _________ part-or-full-time paid or non-paid masseuse or escort harlot _______ cohabitating ________ separated or annulled _________ divorced _________widowed
13. Have you knowingly or non-knowingly produced or perhaps produced any children of your own? ______ No ________ Yes
14. Can and do you want to produce children of your own? _______ No _______ Yes
15. Should you or your spouse ever use pregnancy preventers, such as pills or condoms? _______ No _______ Yes
16. Where do you usually live? _______ At home alone _______ At home with parents _______ In an apartment alone _______ In an apartment with roommate(s) ________in a college dorm, fraternity, or sorority _______ sometimes in storage unit or vehicle
17. Do you rent living quarters wherein you reside? ______ Yes ______ No
18. Do you own your living quarters wherein you reside? _______ Yes _______ No
19. What vehicle(s) do you own and mostly use? ______ Car(s) _______ Other vehicle(s)
20. Do you have a Driver's License? ___ Yes ___ No If so, for what State? (Specify: ______________________)
21. Do you have, or have you had, a Police Record for Gross Misdemeanor or Felony? _______ Yes ______ No
22. Have you ever been at least temporarily imprisoned for court conviction? _____ No ______ Yes
23. If you served in the Military, in which Branch: (Specify: ________________________)
24. What outstanding loans do you owe? ____ Vehicle loan ____ Mortgage ____ Student Loan ____ Other Loan(s)
25. Do you have and use a debit or credit card? ______ Yes _______ No
26. How much do you presently have saved? ______ under $1000 _____ over $1000 _______ well over $1000
27. Are you currently enrolled in an educational institution? _______ Yes _______ No
28. Are you a Vo-Tech or College Graduate? ______ Yes ______ No
29. Are you now employed? ____ Part-time ____ Full-time ____ Laid-off ____ Collecting SS or Unemployment
30. General occupation you get paid for? (Specify: __________________________________)
31. Main avocation(s) or hobby you are occupied with? (Specify: _________________________)
32. Have you ever smoked cigarettes or cigars? ________ In the past ________ Occasionally _______ Never
33. Have you ever drank alcholic beverages? _______ In the past _______ Occasionally ________ Never
34. Have you ever been drunk so as to see hallucinations, stagger or vomit? _______ No ______ Yes
35. Do you eat low-sodium foods, and those with sugar instead of sucralose or aspartame? _______ Yes ____ No
36. Do you eat pork and beef well-done instead of medium-rare bloody pink? _______ Yes _______No
37. Type of dancing you would do? ______ Slow waltzing only with same opposite-gender partner _______ Square Dancing with different opposite-gender partners ________ Modern wild-movement dancing ________Square dancing with same-gender partners
38. What Bible translations do you prefer? ________ KJV mainly _______ RSV, NASB, ESV _______ other Protestant Bible translations _______ other religious texts
39. The types of sounds you prefer? _______ Rich-theology chorale-type traditional hymnbook hymns _______ Easy listening jazz _______ Orchestral instrument music ________ Brass band music ______ Overly-repetitious childish praise songs with simplistic lyrics _______ Boom-boom-bass run-on-lyrics rap noise
40. The types of background music in stores and restaurants you do not object to? ______ Male vocalists ______ Muzak instrumental-only easy listening _______ erotic-sounding or noisy female vocalist
41. Gender of newscaster you prefer listening to? ______ Relaxed-sounding male ______ Feminist-sexist female
42. Do you have any tattoos or piercings on you? ____ None ______ On arm ______ Elsewhere on body
43. Many types of non-violent weapons are available at gun shops and clubs, and elsewhere, which do not shoot nor decide to shoot targets by themselves. What are you favorites? _____ Beretta ______ Smith & Wesson _______ Glock _______ Ruger ______ Sig Sauer ______ Others
44. The best way(s) to physically silence or muffle an audibly noisy post-infant toddler to quit being a public nuisance: _______ Cup your hand over the nose-breathing child's mouth until they stop their disturbance ________ Take them out to the car and temporarily leave them there with windows closed _______ Momentarily turn them upside-down inside a lavatory ________ Put a cookie in each hand and one in their mouth ________Take them home and spank their butt
45. You use fingernail and/or toenail polish? ________ Never _______ Not now, but have in the past
46. You use perfume? _________Never _______ Am allergic to it ________ Have in the past
47. You use lipstick or eyeshadow? _______ Never ______ Have in the past
48. Is it natural and appealing for crotch hair to be shaved according to Isaiah 3:17 and Ezekiel 16:7? _____ No _____ Yes
49. Wear contacts or glasses for nearsightedness? _______ No _______ Yes
50. If you have longer-than-mouth-level hair, how do you modestly display it when in public? _______ In an up-do ______ tied into a back-of-head ponytail
51. When in public during warm weather, do you consistently wear long or somewhat-short-sleeved garments? ______ Yes _____No
52. When in public during warm weather, do you consistently wear full-length pants, slacks, or trousers? ______ Yes _____ No
53. When in public during warm weather, do you consistently wear socks with whatever type of shoes? ____ Yes _____No
54. Do you sometimes utter vulgar four-letter words? _____ No ______ Yes
55. Do you sometimes utter God's name profanity? ______ No _____Yes
56. What major or minor surgical operations have you had? ________________ Major ______________ Minor ___None
57. Are you crippled in any way? ____Yes ___ No If so, how? (Specify:_____________________________________)
58. Ever been administered chemotherapy or radiation for cancer? ______ No _______ Yes
59. Do you have asthma, allergies, convulsions or tremors? _____ No _____ Yes If so, which? (Specify: _____________________________)
60. Ever been vaccinated or have no incurable or terminable diseases? _______ Yes _____ No
61. Ever had any broken bones? _____Yes _____No
62. Do you think that those vandalizing the property of others with spray-paint graffiti should be arrested, fined, perhaps imprisoned, and maybe even executed? ______ Yes _______ No
63. Do you admire the warm-weather modesty of old-order nuns, amish, and islamic wearing burka or hijab? ______ No ______ Yes
64. Do you agree with those who say that murdering womb babies by committing and not performing abortion homicide is a "right?" _____No ______ Yes
65. Do you have any friends (not acquaintances) who support those claiming to be homogay? ____ No ____ Yes
66. Do you believe in anti-scientific evolution instead of Divine Biblical creationism? ______ No ______ Yes
67. Do you support the State of Israel? _______ Yes ______No
68. Do you advocate Israel giving away their land to anti-Zionist "palestinians?" ______ No ______ Yes
69. Would you shake hands for greeting your opposite-gender partner on a first date? ______ No ______ Yes
70. Would you hold hands with your opposite-gender partner on a first date? _______ No _______ Yes
71. Would you give a cheek kiss to your opposite-gender partner on a first date? ______ No ______ Yes
72. Would you give a lips-on-lips kiss to your opposite-gender partner on a first date? _____ No _____ Yes
73. Would you briefly hug your opposite-gender partner on a first date? ______ No ______ Yes
74. Would you do extended and kissing hugging with your opposite-gender partner on a first date? _____ No ______ Yes
75. Would you lay with your clothed opposite-gender partner on a first date? ____ No ____ Yes
76. Would you fondle any publicly-non-exposed body parts underneath or without your opposite-gender-partner's clothes on a first date? _______ No ______ Yes
77. Type(s) of physical activities you like: ______ Tennis ______ Walking ______ Jogging ______ Bicycling ______ Bowling _______ Golf _______ Swimming _______ Wading _______ Swinging on a Swing ______ Trampolining ______ Skateboarding _____ Gymnastics _______ Ice Skating _______ Downhill Skiing ______ Hockey _______ Basketball _______ Frisbee Throwing ______ Volleyball _______ Football ______ Soccer _______ Badminton _______ Croquet ________ Motorboating _______ Sailing ______ Attending Concerts _______ Attending Church Together ______ Attending Fairs or Conferences
78. You, not your date, pay for vehicle fuel? _____ Yes _____ No _______ Both pay
79. You, not your date, pay for movie tickets or out-of-state motel costs? ______ Yes _______ No ________ Both pay
80. You, not your date, pay for lunch or dinner out food costs? ______ Yes ______ No _______ Both pay
81. Religious-Text Devotional Reading and Short Prayer is advisable to do on a first date? ______ Yes _______ No
82. Calender date you are filling out this Mate-a-Thon Application and Questionnaire? ______ Day _____________________ Month _____ Year