Relationship Interests and Demographics Survey

   1
    What is your gender?
    [______]

   2
       What is your age?

    15-18
    19-21
    22-25
    26-30
    31-39
    40+

   3
       What is your sexual orientation?

    Heterosexual
    Bi-sexual
    Homosexual

   4
       Rank in order which of the following topics as they are interesting to
       you? (with 12 being the higest score and 1 respectively, the lowest)

    1 2 3 4 5 6 7 8 9 10 11 12
    Science / Mathematics
    Movies
    Television
    Technology
    Literature
    Food/Drink
    Pets/Animals
    Music
    Art/Theater
    Politics/Law
    Sports
    Religion/Philosophy

   5
       List some topics of interests that you think people of your opposite
       gender would probably find important to them

    Answer Option 1 ____________________________________________
    Answer Option 2 ____________________________________________
    Answer Option 3 ____________________________________________
    Answer Option 4 ____________________________________________
    Answer Option 5 ____________________________________________

   6
       List some topics of interests that people of your own gender find to be
       important.

    Answer Option 1 ____________________________________________
    Answer Option 2 ____________________________________________
    Answer Option 3 ____________________________________________
    Answer Option 4 ____________________________________________
    Answer Option 5 ____________________________________________

   7
       Rank in order of preference from 1-10 (with 1 being your least choice)
       which of the following movie genres most interests you.

    1 2 3 4 5 6 7 8 9 10 11
    Comedy
    Action
    Fantasy/Science Fiction
    Romance
    Romanctic Comedy
    Art
    Drama
    Indy
    Foreign
    Animation/pixar
    Documentary

   8
    What current event or topic in the news most interests you right now?
    ____________________

   9
    What characteristic or attribute do you look for in a person of the
    same gender that you would like to get to know better?
    ____________________

   10
     What characteristic or attribute do you look for in a person of the
     OPPOSITE gender that you would like to get to know better?
     ____________________
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