First name* Last Name* Gender* male female Date of Birth*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
1940 1941 1942 1943 1944 1945 1946 1947 1948 1949
1950 1951 1952 1953 1954 1955 1956 1957 1958 1959
1960 1961 1962 1963 1964 1965 1966 1967 1968 1969
1970 1971 1972 1973 1974 1975 1976 1977 1978 1979
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Address for correspondens* Phone + area code (home, office or other) E-mail* Marital Status* married single Education* What is your occupation?* Do you know Ukrainian language?* Yes No Languages/What languages do you know?*
English
German
French
Spanish
Italian
other
Do you have a driving licence?*
Yes
No
Do you have a foreign passport?* Yes No Your interests* Color of eyes*
blue
green
grey
brown
Color of hair*
blonde
brown
light brown
red-haired
black
silver
other
Length of hair*
bald
average
short
long
Body parameters (chest/waist/hips)* Height, cm* Weight, kg* Size of shose* Size of clothes* Are you satisfied with your body?*
Yes
No
If you are keen on sport, what is it?*
Yes
No
Are you good at choreography? If yes, tell about your achievments*
professional
amateur
No
Are you good at singing? If yes, tell about your achievments*
professional
amateur
No
Did you take part in shooting?*
Yes, professional actor
Yes, fashion model
Yes, amateur
No
What extra information about yourself you want to tell?* Photo 1* Photo 2* Photo 3 Photo 4 Photo 5 * It is obligatory for filling in.
Please add your photos (not less than two photos), which are describe your appearance as much as possible (a portrait, full growth, in a swimming suit, a stage image).
All questionnaires are intended for using by organizational department of «AdiozProduction» company and will not be used in comercial purposes without the preliminary agreement with the author of the questionnaire.
