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Registration

How to do it?

  1. Fill this registration form.
  2. Please, don't forget to send your best pictures to agency@planetromance.cz.. If you only have paper photographs, you can send them to our contact address and we will scan them digitally.
  3. Please send to us your payment for chosen program. The methods of payment are published in the section Price List. As soon as we'll receive your payment we'll active your user's account and you'll can start to select women, to whom you will be introduced.

WE PROTECT YOUR DATA!!

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* - Fill one of them, please.

Your ID number: 8391

Your product: Choose your product
Select membership that will be the most suitable for you, please think about this properly because every membership includes different extent of our quality services.
Your new password:
First Name:
Lastname:
Birth Date: (DD.MM.YYYY) . 
Address (for correspondence):
E-mail:
* Telephone (mobile):
(In international format, please)
* Telephone (private/business): (In international format, please)
The optimal time for you, when we can contact you: 
Where have you learned about us?:
Children:
Number:
Children in
my custody:
Their age:
Marital status:
Education:
Nationality:
Place of Residence:
Country (origin):
Country (present):
City:
Occupation:
Build:
Height (cm):
Weight (kg):
Hair:
Color:
Length:
Eyes:
Smoking:
Drinking:
Languages:
LanguageKnowledge level
1. 
2. 
3. 
4. 
Religion:
General Description:
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Description
 Hobbies and Interests


Partner Requirements
Age: From to  years
Describe the lady you would like to meet:
Write something about you or write message to partner:
(will not be translate)
Message to agency:


 I agree with this affirmation

 I agree with having my data included in the catalogue and the search system of PlanetRomance for women. My personal profile will not be publicly accessible, only the female clients of PlanetRomance will be able to see my profile.

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                Last updated: 7.9.2010