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Membership
Form
Once
you have completed this form, you will be taken
to a page where you may pay the registration
fee online by credit card or by check. Fee must
be paid prior to membership activation.
Contact
Information:
INFORMATION IN THIS COLUMN WILL NOT APPEAR
IN YOUR PROFILE. IT IS FOR OUR OFFICE USE
ONLY. Your
first and last name **
Your
eMail Address
**
Re-enter
eMail Address **
Your
phone number with area code **
Your
mailing address, including city, state/province,
postal code (for billing only)**
SIGN
ME UP FOR:**
6
month membership:
$45 + $25 setup fee = $70
12
month membership:
$65 + $25 setup fee = $90
REFERRED
BY: If you were referred by a current ChristianScienceSingles.com
Member, please type their name here:
Special
instructions/questions
PHOTO(S)
FOR YOUR PROFILE: Photos
are optional. If you do not include your photo(s)
our "sketchy heart logo" will appear in its
place in your Profile.
Sending
your photos: We prefer to receive your photos
by eMail. We will
size
them here.
Photos should be at least 350 x 500 pixels.
Not sure what size they are? Send them to
us anyway. eMail
your photos to us or mail it
to: CSDirectory.com, 1610 W. Oregon Avenue,
Phoenix, AZ 85015-9010
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Your
Profile Information
The
information
below will be used to create your Member Profile.
What
USERNAME would you like to
use?**
[6-12 characters (letters/numbers) - lower
case]
What
PASSWORD would you like to
use?**
[6-12 characters (letters/numbers) - lower
case]
We
will eMail you your password once your membership
is activated. You will use your username and
password to access the Members' Area and your
Private Messages.
MY
AGE GROUP: choose one**
20 - 29
30 - 39
40 - 49
50 - 59
60+
FROM:
give a general idea of where you are, like
"state" or certain "metro-area"
This will appear in your Member Profile AND
in your Introduction on the public side of
the site. **
MY
INTRODUCTION: Sell yourself! This
will appear in your Member Profile AND in
your Introduction on the public side of the
site. Keep it to 50 words.**
RELATIONSHIP
I AM LOOKING FOR: What type of relationship
are you looking for? a like-minded friend
to talk to or eMail, someone to do things
with, a more serious relationship, a marriage
partner? etc. This will appear in your Member
Profile AND in your Introduction on the public
side of the site. **
QUALITIES
OF THE INDIVIDUAL I AM LOOKING FOR:
**
MY
OCCUPATION / EDUCATION:
**
CHILDREN: Mention
if you have kids, if they live with you, if they
are grown, etc.**
MY
INTERESTS/HOBBIES: **
MY
PERSONAL CHARACTERISTICS: personality,
any physical attributes you'd like to mention,
etc., focusing more on the "whole person"
**
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