Tell Us What You Think

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First Name:
Age:
Sex:		Male Female
Orientation:		Heterosexual Homosexual Bisexual
Experience with online dating:		None Less than one month 1 - 3 months 3 - 6 months 6 - 12 months Over 1 year
List any online dating sites you have personally used:
Describe your experience with each site:
May we contact you via email to discuss further?		Yes No
Email Address:
Comments: