* 1. Your Gender?

* 2. Age

* 3. Have you ever been married?

* 4. How long have you been single?

* 5. How frequently do you date?

* 6. When was the last time you dated on a regular basis?

* 7. Would you like to marry or find a long-term companion?

* 8. How do you feel about marrying or finding a long-term companion?

  1 100% Pessimistic 2 3 4 5 Equally Pessimistic and Optimistic 6 7 8 9 10 100% Optimistic
1

* 9. Are you currently sexually active?

* 10. If you are not currently dating, what are the primary reasons for not doing so (please list all that apply)

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