Natural Hair Color: [x] Brown - $10.00 [] Blonde - $7.50 [] Black - $1.50 [] Bald - $0.50 [] Other - $5.00
Eye Color: [x] Brown - $5.00 [] Green - $10.00 [] Blue - $15.00 [] Hazel - $7.50 [] Other - $1.50
Height: [] Over 7′ - $20.00 [] 6′8″ to 7′ - $17.50 [] 6′0″ to 6′7″ - $15.00 [x] 5′5″ to 5′11″ - $7.50 [] 5′4″ to 5′10″ - $8.50 [] Under 5′4 - $9.50
Age: [] 50 to 56 - $17.50 [] 46 to 50 - $15.00 [] 41 to 45 - $12.50 [] 31 to 40 - $10.00 [] 26 to 30 - $7.50 [x] 21 to 25 - $5.00 [] 19 to 20 - $2.50 [] 0 to 18 - $10.00
Birth Order: [] Twins or more than twins - $75.00 [] First Born - $32.00 [] Only Child - $25.00 [x] Second born - $15.00 [] Middle child - $10.00 [x] Last Born - $10.00 [] third born - $55.00 [] fourth born - $30.00 [] fifth born - $40.00 [] sixth born -$21.50
Drink? [] I did like once - $40.00 [] Only Holidays or Occasions - $25.00 [x] Sometimes - $21.50 [] YES - $20.00 [] only weekends - $30.00 [] Every other day - $5.00 [] Once a day - $1.50 [] I live from the bottle - $Bankrupt$ [[back to $ZERO]] [] No - $60.00
Vision? [] perfect vision $40.00 [x] need/have glasses/contacts but don't wear them $20.00 [] No correction $10.00 [] Glasses $5.00 [] contacts $2.50 [] Surgical correction -$10.00
Shoe Size: [] 13+ - $30.00 [] 12 and a half to 13 - $25.00 [] 11 to 12 - $40.00 [x] 7 to 10 - $50.00 [] Under 7- $45.00
Favorite Colors (two): [x] Green-$75.00 [x] Red - $60.00 [] Black - $10.00 [] Yellow -$47.50 [] Brown - $30.00 [] Purple - $22.50 [] White - $40.00 [] Aqua - $35.00 [] Orange - $30.00 [] Blue - $30.00 [] Pink - $10.00 [] Other - $50.00
Bedroom walls- select all that apply! [x] white - $11.00 [] green - $33.00 [] black - $11.00 [] purple - $22.00 [] orange/red/yellow - $33.00 [] blue - $22.00 [] other - $35.00
First letter of the person you last talked to [] a,b,c,d,e,f,g,h,i - $10.00 [] j,k,l,m,n,o,p,q,r - $5.00 [x] s,t,u,v,w,x,y, - $20.00 [] z - $25.00
Total:$315
Did you use a calculator to add it all up? [] Yes $0 [x]Nope- $100.00 [] some- $75.00
