Home
Any information supplied is for internal use by authorized personnel only.
Under no circumstances will any information supplied to use be
released to outside parties for any reason.
We respect your privacy.

SECTION 1 - ABOUT ME
fields marked
with and * asterisks are required

Create your login and password to access your personalized resources as we create them

We will use your e-mail address as your login.
Please also provide us with a password for your account.
(this does not have to be the same password that you use
to access your e-mail account)
*E-Mail Address 
*Password 
*Repeat Password
*Where did you hear about Young at Heart Which Publication

* Title * First Name
* Last Name
*Occupation
 
* Please provide a convenient contact number.
This will be used only for our consutant to contact you.
The best time to contact me is: Mobile
Home
At Work
   
This will be used to ensure we service the area you are in.
*City
*State
* Suburb   *Post code

These fiields are not compulsory
Address   Geographic Direction
Job Title Education  
       

I am interested in

Companionship Expanding Personal & Social Contacts
Friendship Relationship
Expanding Personal Contacts Marriage / Re-Marriage

My marital status is 

I am

Female Male

Children?:   Girls(ages) Boys (ages) Living with you ?

I am:              
Height Weight Hair Colour  Eye Colour
Age Star Sign Nationality  Ethnic Background


Date of Birth
*

Smoking: Drinking: I have Pets
YOU HAVE REACHED THE END OF OUR COMPULSORY SECTION

FOR QUICK REGISTER CLICK Submit here or ............continue to provide a fuller profile


You may wish to provide additional information to assist your consultant at a detailed interview
Section 1 About Me
(cont'd)
If you prefer to make multiple selections hold down control key and click

Activities

Physical

 

General

 

Arts

Music

 

In my free time I:
My best trait is:
My worst trait is :

End of Section 1 About me

Submit here or continue to provide a fuller profile


You may wish to provide additional information to assist your consultant at your detailed interview

SECTION 2 ABOUT MY PARTNER

His/Her Nationality : give options

His/Her age : between and His/Her height : between and

( Hold down control key & click to make multiple selections = (Optional)

His / Her Marital Status:

Children:
Smoking:
Drinking:

Interests they would like the share with you (optional)


Please provide some characteristics of the type of person to which you feel attracted.


Submit here or continue to provide a fuller profile


Optional Information. Things to think about and plan. This can help us and others know some things that turn you on!
1. What are your 3 Favorite Books?
2. What are 3 places you'd like to go to but have never been?
3. The films I am most likley to watch are?
4. What are 3 things you would like to share with a partner and have yet to do?
5. What are your 3 Favorite Cuisines?
6. Where would you like to spend a romantic weekend for two (Within New South Wales)?
7. What are your 3 Favorite Wines?
8. Where would you like to spend a week with someone special in Australia?
9. Television programs I am most likely to watch are.
10. You now have someone special in your life and you are going overseas for 2 weeks. Where would you go?
11. What are your 3 Favorite Outdoor Pursuits?
12. If you had to choose a romantic location in Sydney to go on a date which one would you choose?
13. If you were planning a romantic day out, where would you like to go?
14. As a woman, if you were to share a mans' pursuits for a day which ones would you be willing to share?
15. As a man, if you were to share a womans' pursuits for a day which ones would you be willing to share?

WOLLSTONECRAFT STATION (Lower North Shore) Ample free parking
Easy access, 1 minutes walk from the station
Monday-Friday 10:00am-8:00pm
Saturday 10:00am-6:00pm
By appointment
Phone (61-2) 9436 2346

© Young at Heart 2005
Find the service that's right for you
. Visit these helpful links: