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Name

First name

Email

Age:

Origins:

Relationship Status:

Single

divorcee)

widow/widower

Separate

I participate alone in speed dating:

Yes

No (If no, please provide the names of your friends in the next question!)

I participate with friends! Last names, first names, age of friends:

What I look for in the other:

I have children:

Yes

Do not

If yes how much?

1

2

3 or

My studies / My training:

I define myself as:

The return to the country is:

My dress style:

My musical tastes:

My spirituality/ My religion

The last Afro book I read:

Natural hair:

My telephone:

Free space:

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