As this is a personal Service, registration
is always made personally. We can meet you anywhere, any time convenient to you
for registration. Please send a message
HERE and we will contact you.
Please have in mind that any information
given in the form below to be submitted on line, is for our own use and those
are never given or revealed to anyone for any reason. If there is something in
the form that you are not willing to give, feel free to leave it empty and we
can talk about it during our meeting.
Although the registration will be made
personally, we would request you to submit this pre registration on line, which
of course is not binding and it can be cancelled.
The Registration Fee in R.M.B. is only
€500.00
You can pay during our meeting or you can pay on line using the link below:
If you want to pay on line, this amount is refundable if at our personal
meeting you decide not to proceed
If you are already a member, you can be
registered at the Rich & Millionaires at a reduced Registration Fee or even
for FREE on condition you fulfill the requirements. Please
complete the form below and submit it. We will notify you if you are accepted or
not
Pre-Registration Form
Name or Nickname
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
***
Mobile phone
***
Home Phone
FAX
Valid E-mail
***
Please identify and describe yourself:
Date of Birth
***
Sex
Male
Female
Height
Weight
ID Number
Hair Color
Eye Color
Looks:
Physical type
Education:
Spoken languages
English
French
Greek
German
Italian
Spanish
Others Specify:
Your profession:
Marital status:
How many children do you have. ?
Clarification about your children:
Under 18 Live with me
Under 18 Do not live with me
Over 18 Live with me
Over 18 Do not live with me
Religion:
Citizenship:
Country of birth:
Country of residence:
Since when do you live in Cyprus?
Where do you want to live?
Do you smoke?
Do you drink?
Do you take drugs?
What kind of relationship do you seek?
The person you wish to meet:
Minimum age:
Maximum age:
Your preference about his/her smoking:
Your preference about his/her drinking:
Your preference about his/her marital status:
Single
Separated
Divorced
Widowed
Any
Describe the person you wish to meet
Additional information you may wish to give. Important subjects that concern you
Additional space for your comments
Pre- Registration:
Declaration I declare that the information
given in this application form are true and correct. In case I change
my address or any of my contact details I will inform you about this well in
advance.
I understand that after submission of this form, you will arrange a
personal meeting with me so as to help me take final decision.
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