Name   Surname
 
     
Date of birth   Nationality
 
     
Single
Married
    
     
E/mail address   Phone
 
     
Interests
Restaurants
Bars
Nightclubs
Travel
Sport
Fashion
Others
 
How did you hear about Xpat Life:
Xpat Life Website
Twitter
Facebook
Search engine
From a friend
Others
 
     
How often do you like to go out or attend events each week?    
   
     
Are you a member of any other private member clubs or social clubs?    
Yes
No
   
     
If yes, which ones?