1. The purpose of this survey form is to gather the information and examine on how people choosing their
mate in term of psychology. Your participation in this research project is entirely voluntary. In order, for
the information you provide to be useful, it is important that you answer these questions fully and
candidly. To ensure confidentiality of you responses please return the questionnaire immediately
after completed these questions and please do not include your name on the questionnaire.
1. Are you in a relationship?
Yes
/
No
2. Based on your opinion choose 3 factors that you think is important when selecting a mate. (Please
tick
)
Factors
Kindness
Intelligence
Physical Appearance
Highly Educated
Healthy
Wealthy
Religious Orientation
Family Background
3. What range of age difference is acceptable?
1-5 , 6-10 , 11-15 , 16-20 , 21-25 , 26-30 , None of the above
4. Could you accept long distance relationship?
Yes
/
No

2. 5. Would you consider dating someone from a different race than yours?
Yes
/
No
6. Could you accept bad family history background such as drug addiction?
Yes
/
No
7. Do you think online dating works?
Yes
/
No
If yes, will you do?
Yes
/
No
8. Do you think speed dating works?
Yes
/
No
If yes, will you do?
Yes
/
No
9. Do you think blind date works?
Yes
/
No
If yes, will you do?
Yes
/
No
END
Thank you for the participation