"SPECIAL SERVICE" FOR MEN

ORDER FORM

I wish to take part of your special service during 6 months and enclose the sum of ________ as payment (No cheques) Please use BLOCK letters or type your ad!

Name:___________________________________________________________________

Street or Box:______________________________________________________________

Zip & City:_______________________________Country:__________________________

Profession:___________________________Age:______________Height:______________

Hair:_______________________ Eyes:_____________________ Weight: _____________

Are you: Single ( ) Widower ( ) Divorced ( ) Which languages do you speak? _________________________________________________________________________

Your hobbies / interests: Reading ( ) Music ( ) Sports ( ) Animals ( ) Going out ( ) Travel ( ) Art
( ) The Sea ( ) The country ( ) Other:
_________________________________________________________________________

Do you want to know a girl for: Friendship ( ) Marriage ( )

Underline: The qualities & shortcomings considering yourself: You are: Courteous, Cheerful, Kind, Understanding, Loyal, Affectionate, Punctual, Gloomy, Shy, Distant, Sensitive, Frank, Sincere, Commanding,Energetic, Economic, Others: ________________________________
_______________________________________________________________________

BONUS OFFER: Your advert is printed also in a Russian paper without extra payment. Send at least one additional photo. ( ) Yes, I would like to participate

PLEASE NOTE IT WILL TAKE 1 - 2 MONTHS TO PUBLISH YOUR AD.

Print, fill out, and mail your order and payment to:

Rawemark Agencies, P.O.Box 77, FI-00251 Helsinki, Finland

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