Use ball point pen. Nor
pencils or felt pens please.
The following statements are intended for matching attitudes and values. Plea
the number closest to your reaction.
Most computer date match services are for losers. You've heard the pitch - "lonely, divorced, widowed." Who would sign up
a date match like that?
This computer date match is for everybody - jocks, jerks, junkies, jesus freaks; spare changers, tire changers; modern artists, c
artists; smokers, tokers; rah-rah's, rednecks; oversexed, undersexed; AM listerners, FM listeners; TV watchers, bird watchers; fe
sitters, baby sitters; penny pinchers, penny pitchers; tacos, mataoh balls; anarchists, reactionaires; hippies, narcs; U of. M Poli
Greeks, dormies, townies; boozers, teetotalers; easy on the onions, heavy on the ketchup - even you: Mr. and Ms. U of M Public.
Our computer can quickly search through thousands and find those special types with whom you are most likely
communicate and enjoy dates. There is no easy way we can predict you'll have a dreamdate. But even if your matches don't h
that "special pazazz", the sharing of many interests, attitudes and values will open a channel for a rewarding friendship.-
THIS IS HOW IT WORKS
First, answer the questions below as honestly as possible. Mail the form to us with your check or money order for $3.00
$2.60 for those mailed in groups of six or more. The deadline for applications is Friday, February 27.
Our computer will compare your responses with those of all others and report the closest matches. Along with each match's fi
name and phone number, you receive from the computer three separate scores of similar interests; attitudes and values; a
appearances and background. You make the final decision on what's more important. You will receive between three and fifte
matches. If the computer can't find at least three we will refund your money. All participants in the program are invited free to
UAC Computer Date Match Dance, Friday, April 2, non-participants will be charged at least $1.00 to attend.
All information on your application will be held in strict confidence. Only your first name and telephone number will
released to others. The data you supply will be used only for matching you with a compatible date. No data will be sold or in a
way released to another group. Anyone getting your name will also be on your list so you may be certain that those who call
identify themselves really are computer date matches.
To participate in the UAC Computer Date Match:
" You must be at least eighteen years old and single
" You must be a registered student, faculty or staff member at University of Michigan, Ann Arbor
* You must not annoy any of your matches should they decline to get acquainted
Send completed form and a money order or check made out to
the University Activities Center for $3.00 (S2.50 if 6 or more forms UAC COMPUTER DATE MATCH
are enclosed in the same envelope) to: SECOND FLOOR, MICHIGAN UNION
Use ball point pen. No pencils or felt pens please. ANN ARBOR, MICHIGAN 48109
It is important for you to place an answer in each appropriate box. Items with a + MUST be answered. Think
carefully. The following items will eliminate from your prospective matches those persons whom you would not
*1 am: 1-male. 2-female.
+My height is: ft. and L inches.
My match must be no more than: inches shorter or
inches taller than I am.
*My age is J years.
My match must be no more than: E]years younger or
years older than I am.
My match must drink no more than:
My match must drink at least: n1-never.
+1 smoke: 2-sometimes in a group or rarely.
My match must smoke no more than: 3-occasionally.
"l might smoke pot: 4-often.
My match must smoke pot no more than:
*My attitude on drugs is: 1-never take drugs. 2--open mind on soft drugs.
My match's attitude on drugs must be no more liberal than: 3-open mind on hard drugs.
' \~N' 1 am: 1-undergraduate. 2-graduate/professional.
My match must NOT be (if it matters): ~~ 3-faculty/staff.
+1 am: 1-American. 2-foreigner.
My match must NOT be (if it matters): 1-American._2-fregne__
*My race is:L 1-Black. 2-Caucasion. 3-Oriental. 4-Am. Indian.
My match's race must NOT be (if it matters): E L LIII5-Latino. 6-Arab. 7-India Indian.
S*My religion is: 1-no religion. 2--Catholic. 3-Protestant. 4-Jewish.
5-Christian. 6-Greek Orthodox. 7-Moslem.
My match's religion must NOT be (if it matters): f21I ][11DD]8-Unitarian. 9-Quaker.
The following items will be used to select matches on the basis of background and appearances.
+My hair color is mostly (enter two if mixed):DD 1-Black. 2 Brown. 3--Blonde. 4 Red.
I prefer match's hair (ranked favorite to least favorite): ___
*My hair length is: 1 -shorter than average. 2-average.
I prefer my match's hair length to be: 3--longer than average. 4-much longer than average.
*(men) I have: HE'1-clean shaven face. 2-moustache.
(women) I prefer: L 3-side burns. 4-beard.
+(women) I wear make-up: 1-never/little. 2-special occasions.
(men) I prefer matches who wear make-up: 3-regularly.
*1 spend approximately: dollars per year for clothes
*My weight is: pounds.
*The highest level of formal education 1-grade school. 2-high school. 3-two year college.
completed by my father or mother was: 14-four year. college. 5-graduate/professional.
My family's annual income range is: 1-less than $8,000. 2-$8,000-$15,000-
3-$15,000-$35,000. 4-more than $35,000.
1 grew up mostly in a. 1-rural/small town. 2-medium sized city.
I prefer my match to be from. 3-larger city. 4-large metropolis.
Now let's find where your
special interests are.
p leaves me cold/not interested
R no experience but interested
familiar with it and interested
.Q3 much into it
8 Scuba Diving
 Spectator Sports
0 Play a Musical Instrument
0 Dancing at Dances
Science Fiction -
Painting and Drawing
Arts and Crafts
Play Production and'Acting
8 Political Campaigning
If we missed any, you may
write in special interests which
you are much into (please print):
1 Strongly Disagree
7 Strongly Agree
Most of my friends regard me as a sensitive person.
I feel I am ready to settle down and get married.
I usually put things away when i finish using them.
A person can be very moral without being religious.
Q I would prefer to have a well-maintained old house rather than a new house.
Q Marijuana should be legalized.
Q Movies deal too explicitly with sex today.
I might marry after I knew my partner for only a short time if I knew I was in Ik
Q The great majority of our elected officials are really quite honest.
E] Two single people who are only strongly physically attracted to each other sho
intercourse as often as they like.
When you fall head-over-heels-in-love it's sure to be the real thing.
One isn't really a well rounded person until one has sexual relations with severa
I find myself reluctant to make close friends with someone of another race.
Q I could not condone the killing of another human being, even in war.
H I read the newspaper's editorial page frequently.
I believe in a Supreme Being who controls our destiny.
I belong to many clubs and organizations.
I am punctual and rarely miss an appointment.
A couple should live together for a while before getting married.
] if a member of my family wanted to marry someone of another race, I would tr
him or her out of it.
I might quit a higher-paying job to work at something personally rewarding.
QjSex education should not be taught in the public schools.
I would be reluctant to become friends with a homosexual of my own sex.
I find myself frequently afraid to accept new challenges.
There are probably only a few people that I could really fall in love with.
I am proud of my body and i love to show it off.
Q I attend religious services regularly and I would prefer a date who does also.
H I would vote for a woman as President of the U.S. if she were qualified.
I 1 am affectionate and usually don't hesitate to express my feelings.
Q If my country were in danger of being overcome by a foreign enemy, I would
my life to help save it.
Q I am willing to sacrifice much of my social life in order to achieve my academic
Love is best described as an exciting thing rather than a calm, peaceful thing.
HI would like to have a large family.
I feel ill at ease when someone tells a dirty joke in mixed company.
EWhen I hear a good joke, I usually remember it and relate it to my friends.
8 easily get angry.
Each person should pay their own way on a date.
I definitly plan to go to graduate school.
I believe that if I were wealthy, most of my problems would take care of themse
Q I would probably cheat on an exam if my degree were in jeopardy and if th
little chance of getting caught.
I am going to college because my parents urged me.
i often like to spend some time by myself.
Working wives are deserting their families for a career.
I usually try to make detailed plans for tomorrow's activities.
I believe in a God who answers my prayers.
I would rather do things with others than by myself.
Parents have a responsibility to provide religious training for their children.
I would have premarital intercourse with someone I loved very much.
I am more a listener and follower than a leader.
Q If my child, brother, or sister were charged with a serious crime, I would lie un
to protect him or her.
Q I feel ill at ease when a friend tells me his or her problems.
Q I get a special delight from playing harmless practical jokes on friends.
LThe more in love one becomes, the more jealous one becomes.
Q I like most pets.
first for IIII 111 11I
Include dorm room/apt. no. Include dorm name.
+Your first name or nickname unique to your phone
number (only this name as listed here and your
phone number will appear on each match's report):
*Local phone (if you have none
list a number where you can (313)
+ ENTER ADDRESS CODE:
11. Alice Lloyd
12. Baits 2
13. Barbour-Newberry 2
14. Bursley 24
15. Co-op 2
16. East Quad 26
" 17. Law Quad 2
18. Markley 28
19. Martha Cook
Other on campus
Off campus, give zip
READ CAREFULLY - THIS PARAGRAPH IS A RELEASE OF UAC AND INTERPERSONAL RESEARCH FROM ANY LIABILITY ARISIN
PERSONAL INJURIES AND PROPERTY DAMAGES WHICH YOU MAY SUSTAIN IN CONNECTION WITH THIS CONTRACT. THIS MUST BE
BEFORE WE WILL PROCESS YOUR FORM.
In consideration of the University Activities Council (UAC) and Interpersonal Research's comparing my responses on their form to those responses of
and reporting the closest matches as set down in the above contract, I hereby release UAC and Interpersonal Research, their agents, officers, ser
employees of and from any and all liability, claims, demands, actions and causes of action whatsoever, arising out of or related to any loss, damage
including death, that may be sustained by myself or my property and that subsequently accrue to me by reasons growing out of or in anywise connec
directly or indirectly, services rendered by UAC and Interpersonal Research under this contract. This release shall be binding upon my distributees, hei
kin, executors and adriinistrators.
In signing the foregoing release, I hereby acknowledge and represent: (a) That I have read the foregoing release, understand it, and sign it voluntarily
I am at least 18 years of age and of sound mind; (c) That I am a student, faculty or staff rmenber at the University of Michigan and that UAC has my p
to verify this fact through University records.
C197i s orlcna Ra-arh inc
c... i 1 it . t,
C) 1976 Interpersonal Research, Inc.i
APPLICATIONS CAN BE TURNED IN AT UAC TICKET CENTRAL AT HILL AUDITORIUM 11:00 TO 5:30-DEADI
Stuaent J. U. number:
LINE TODAY, FRIDAY, FEB. 27!