Date Night Awareness Week 27 August - 2 September 2018

INVEST IN YOUR RELATIONSHIP BY ANSWERING THESE VERY BASIC & SHORT QUESTIONS.

Question Title

* Contact Details

Name

Surname

State/Province

Email Address

PLEASE MAKE SURE THAT YOUR EMAIL ADDRESS IS CORRECT. THIS IS OUR ONLY FORM OF COMMUNICATION. CHECK YOUR INBOX FOR MAILS FROM LEILANI@DATENIGHTSA.CO.ZA.

Question Title

* Relationship status?

Married

Engaged

In a relationship

Dating

Question Title

* Your age?

Question Title

* When do you normally go on dates?

Weekends

During the week

Question Title

* Do you have children?

Yes

If Yes, please specify their age

Question Title

* What are your interests?

Food

Picnics

Adventure

Spas

Wine Tasting

Fitness

Entertainment

Travel

Outdoor

DIY

Weekend getaways

Something different

Other (please specify)

Question Title

* Would you like to be contacted by our accredited Date Night Ideas suppliers with special offers?

Yes, thank you.

No, thank you.

IMPORTANT: Make sure your registration is completed in order to receive your 7 date ideas plus your bonus E-zine with 52 date ideas to tide you over until DNAW 2019 and variety of vouchers that you can spend at our affiliated providers. You will receive the above in an email.