Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

Select Personal Introductions

Est.1997. Members from Manchester, Lancashire, Cheshire, Merseyside, Chester / Wirral, North Wales, Cumbria,Yorkshire & Leeds. More »

 

Application Form

Thank you for your interest in Select Personal Introductions, an exclusive OFFLINE introductions and dating service. Select Personal Introductions is dedicated to relationships as opposed to casual dating. So if you are Single, Divorced, Widowed or Separated and are looking for a genuine relationship with a view to setting up home together, getting engaged or married and/or starting a family, then we can help!

Complete our application form today

To properly evaluate your needs and requirements, please complete our application form below and an adviser will contact you for an informal chat. Once we understand you on a personal level we will arrange introductions for you with other eligible singles, who we think, based on years of experience, will suit you best.

*To ensure that our members meet a high calibre of single people then we do (regretfully), have to decline some applications.


About You
Title: Mr Mrs Ms Miss   Other:
Forename:   Surname:
Nationality:   Country of Origin:
Your Appearance:
Caucasian European Asian Middle Eastern Far Eastern
Mixed Race Black/African Other
Accommodation
Address:  
Postcode:
Accommodation Type :
Terraced Semi Detached Detached Apartment
Bungalow Flat
Do you live?
Alone With Parents With Children With Friends/Lodgers
Contact Details
Tel no:   Work Tel no:
Mobile no:   Private email:
Skype Address:
When is the best time to be contacted?
Morning Evening  
How would you like members to contact you?
Home Mobile  
Employment / Education
Your Occupation
Approx. Income (Per Annum)
Your Eductional Level
School College University
Education Qualifications:
No Educational Qualifications GCSE or Equivalent A Level or Equivalent
Technical Qualifications University Degree or Equivalent
Other
What Languages do you speak?  
 
Personal Statistics
Age:   Date of birth
Your height:   Your weight (Gents)
Your dress size (Ladies)   Your Hair Colour:
Your Eye Colour:  
Marital Status  
Single never married Divorced Separated Widowed
Do you smoke?  
Moderately Occasionally Never Trying to give up
Children
Do you have any Children? Yes No
Ages  
How many live with you?  
Politics / Religion
Your political Views:
Left Centre Right No Strong Convictions
What is your religion?
C of E Catholic Methodist Buddhist
Jewish Hindu Muslim Atheist
No Strong Convictions Other:
Are You:
Practising Non Practising
Driving
Do you drive?
Yes-Own a car No Learning Hold Licence-no car
What make of car do you drive?
Colour
Registration no
What is your preferred travelling distance?
60 minutes 90 minutes Northwest & West Yorkshire All areas covered.
Your Interests
Sailing Scuba Diving Swimming Yatching Windsurfing
Water Skiing Snorkelling Walking Cycling Hang Gliding
Flying Rambling Canoeing Golf Keep Fit
Horse Riding Squash Table Tennis Badminton Abseiling
Ice Skating Skiing Snowboarding Climbing Lacrosse
Rugby Football Tennis Hockey Athletics
Running Netball Basketball Archery Parachute Jumps
Bowling Potholing Polo Bungee Jump Archaeology
Fishing Motor Sports Cricket Hunting Volleyball
Bird Watching Embroidery Reading Stamp Collecting Gardening
DIY Bridge Chess Knitting Needlework
Backgammon Jigsaws Cooking Decorating Painting
Photography Flower Arranging Dinner Parties Writing Sculpting
Pool Breeding Animals Dominoes Card Games Vounteer Work
Darts Snooker Ten-Pin Bowling Martial Arts Astronomy
Basket Weaving Calligraphy Origami Dancing Singing
Boxing Fencing Radio Amateur Jogging Crosswords
Theme Park Rides Wine/Beer Making Amateur Dramatics Collecting Antiques
Are you involved in any other activities?
Are there any new activities you would like to try?
Entertainment
What do you watch at the cinema?
Blockbuster British Horror Gangster
Action Adventure Comedy Thriller
Sci-fi Romance Art Films  
How often do you visit the theatre?
Regularly Occasionally Rarely Never
What type of theatre/shows do you enjoy?
Musicals Plays Orchestral Events Ballet
Opera Pantomimes Classics Comedy
Pop Concerts Open Air Concerts  
What are your musical tastes?
Classical Folk Pop/Chart Blues
Soul Instrumental Jazz Dance
Motown Reggae Easy Listening Indie
Rock 60's 70's 80's
90's Country & Western
Do you play any musical instruments?
(Specify)
Dining
Where do you prefer to dine?
Tapas Bars Bistros Restaurants Hotels
Wine Bars Cafes Trendy Clubs Themed Clubs
Pubs American Diners
What are your favourite foods?
Moroccan Mongolian Indian Chinese
Mexican Japanese French Italian
English Spanish Thai Scandinavian
Greek Turkish  
Other
Are there any types of food you do not like?
How often do you drink alcohol?
Moderately Occasionally Rarely Never
What kind of drinks do you prefer?
Beer Wine Spirits
Holidays / Relaxation
Name your last five holiday destinations.
What would be your ideal holiday?
What type of holiday do you prefer?
Activity Cultural Sightseeing Adventure
Beach/Relaxing
Other
What type of books do you read?
What newspapers do you read?
Which magazines do you read?
Which radio stations do you listen to?
Programmes I like to watch on television:
How would you, your family and friends describe your personality?
What are your future goals and ambitions?
Who I’d like to meet: (please tick any or all)
Aged between and
Marital status:
Single Never Married Divorced Widowed Separated
Appearance:
Caucasian/white European Asian Mixed Race
Middle Eastern Far Eastern Black/Africa Descent  
Will you meet someone with children?
Yes No Yes, if independent  
How many children would be acceptable to you?
Will you meet a smoker?
Yes No Casual
Height between:  
Minimum Maximum
Build:
Slim Average Curvy Stocky Heavily Built
Education level:
School College University
Job level:
Skilled Semi Professional Managerial Professional
Retired Entrepreneurial Creative & Media Financially Independent
Describe your ideal partner:
How did you hear about Select Personal Introductions?
Declaration: I confirm that I am over eighteen years old and that the contents of this, my Application Form, are true and accurate and in no way misleading and that I have never been convicted of a serious criminal offence. I understand that if any information I have supplied is found to be false and/or misleading, Select reserves the right to cancel my membership.
I confirm
Please make sure that you tick ‘confirm’. Without this, Select will not receive your completed application.