russian english italian czech slovak french
What's your name? Name surname
Nationality
born in date of birth (1980-12-31)
Address/ residence: Street & number zip code: Town: Country
telephone area code E-mail Subjet
Mailing address (if different)
Pass number Height cm. weight kg.
Marital status: unmarried divorced widow
Number of children
Number of cohabitant children Number of children that would transfer with you in Italy
their names Date of birth of each
Education degree: elementary school Secondary school University
Job/Employement/Profession
I'm a salesman I'm an agrarian I'm an architect I am a craftsman I'm an artist I'm an actor I'm a driver I'm an attorney I work in a bank I'm a dancer I'm bibliographer I'm biologist I'm a librarian I'm a barman I'm a singer I work in a shop I'm an opera singer I'm a business consultor I'm consultant I'm an air-traffic controller I'm a businessman I'm a book keeper I'm a choreographer I work in a hotel (chamber maid) I'm a croupier I work at home I'm a cook I'm a doctor stomatologist I'm a designer I'm a manager I'm a waiter I'm an economist I'm an electrician I'm a soldier I'm an esthete I'm a pharmacist I'm a jockey I'm a photographer I'm philologist I'm a florist I'm a physician I'm a model I'm a judge I work at a wardrobe I'm a jeweller I'm a journalist I'm a tourist guide I'm a air steward I'm a see steward I'm an engineer I'm a clerk I run a factory I'm a nurse I'm a teacher I'm a translator I'm a building contractor I'm lawyer I'm a professional man I run my own enterprise I'm a sailor I'm a mecchanic I'm a doctor I'm meteorologist I'm a teacher in a kindergarden I'm a musician I'm a notary I'm a dental mechanic I'm a workman I'm a hair-dresser I'm a programmer I'm a educationalist I've retired I'm a painter I'm pianist I'm a policeman I'm a porter I'm a teacher of dance I'm a teacher of phisical training I'm a teacher of languages I'm a teacher of music I'm a (secondary school) teacher I'm a psychologist I'm a pilot I'm a pilot I'm a university professor I'm a reception clerk I am a journalist I'm a scientist (research) I'm a tailor I'm a writer I'm a secretary I don't work now I'm stylist I'm a student I'm a travel agent I'm a technic I'm a veterinary ** I'm a policeman
Do you smoke? yes no a little
Languages you understand
arabian armenian bulgarian bielorussian czech Chinese korean german english estonian french finnish finnish greek georgian japanese hungarian hindi italian Jewish ukranian Polish lithuanian latvian moldavian norvegian portugese russian spanish serbo-croatian slovenian swedish turkish tatarian rumenian uzbek slovak esperanto latin
Do you have a driving-licence?
no yes
What is your car?
What is your religion?
I'm buddist I am jewish I'm christian I am believer no I am orthodox I am protestant I am catholic I am musulman
your health:
your handicap:
min age max age min height max height Marital status indifferent only unmarried only unmarried or widow only divorced or widow Number of cohabitant children indifferent 0 at the most 1 at the most 2 Education degree: indifferent only Elementary school or Secondary school only Secondary school only Secondary school or University only University condition for smoke indifferent only not smoking man
Agreement:
I declare to agree, that Maruska agency will not give away my address, unless requested.
And on the other hand I state that:
the enclosed photos have been taken recenty.
the information in this form is true.
Date Signature