1- Full Name:
*
2- Phone Home:
*
3- Cell No.
4- Email:
*
5- Date and place of Birth:
*
6- Height and Weight:
*
7- Complexion: Very Fair/Fair/Wheat/Dark :
*
8- Father's Name:
*
9- Mother's Name:
*
10- Number of siblings and their ages:
*
11- Citizenship:
*
12- Country of Residence:
*
13- Status in North America: Citizen/Landed Immigran/Student/Refugee:
*
14- Mother Tongue:
*
15- Marital Status:Single/Divorced/Widowed/Legally separated:
*
16- Number of children from Previous Marriage(s) with ages:
*
17- Legal Responsibility:Custody/Living with you/Visitation:
*
18- Personal Characteristics: Friendly/Quiet/Social/Sports:
*
19- Smoker/Non-Smoker:
*
20- Consume Alcohol / Drugs:
*
21- General Health: Disability (if any)
*
22- Religious Affiliation: Sunni/Shia/Qadiani/Ismaili/Other:
*
23- Educational Qualifications:
*
24- Occupation:
*
25- Place of Employment:
*
26- Annual Income:
*
27- Criminal Record If yes, provide detail:
*
28- Anything you would like your potential spouse to know about you:
*
29- Your preferred match in your potential spouse:
*
30- One reference from family:
*
31- Two references outside of family
*
32- Your PP size current Photo:
*
33- Are you PAKSEANA member:
*
34- Date:
*
MM
01
02
03
04
05
06
07
08
09
10
11
12
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2012
2013
2014
2015
Pakistan Steel Ex- Employees Association of North America Inc.
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