Personal Data Choices for Potential Partner and Oneself:

(English Translation by Chris Covell -- sorry if there are any errors!)

(Preferences in a Potential Partner)
 
身長
Height
149cm以下 150〜155cm 156〜160cm 161〜165cm 166〜170cm 171〜175cm 176〜180cm 181cm以上
体型
Body Type
やせ型
Slim ふつう Average 太りぎみ Overweight 特に気にしない No Preference
メガネ
Glasses
メガネは好まない I don't like glasses. コンタクトも好まない I don't like contacts either. 特に気にしない No Preference    
「。。。」
Smokers OK? (???)
Physical Condition (???)
非常に気になる I mind it a lot. ふつうであればよい As long as it's about average, it's fine. 気にしない No Preference    
「。。。」
Age Preference
年上希望 Someone Older 年下希望 Someone Younger 同年代希望 Someone the Same Age 特に気にしない No Preference
「。。。」
... by How Many Years
5才位迄 ...within 5 years' difference. 10才位迄 ...within 10 years' difference. 20才位迄 ...within 20 years' difference.    
年収
Annual Income
   〜150万円未満 Less than 1.5 million Yen 150〜250万円未満 Between 1.5m and 2.5m Yen 250〜350万円未満 Between 2.5m and 3.5m Yen 350〜450万円未満 Between 3.5m and 4.5m Yen
450〜550万円未満 Between 4.5m and 5.5m Yen 550〜650万円未満 Between 5.5m and 6.5m Yen 650〜750万円未満 Between 6.5m and 7.5m Yen 750〜一千万円未満 Between 7.5m and 10m Yen
1000万円以上 Greater than 10 million Yen            
学歴
Educational Level
中学卒 Junior High School Graduate 高校卒 High School Graduate 高校中退 High School Dropout 専学・高専・短大卒 Technical College / Jr. College Graduate
専学・高専・短大中退 Technical College / Jr. College Dropout 大学卒 University Graduate 大学中退 University Dropout 大学院卒 Finished Graduate School
大学院中退 Graduate School Dropout            
結婚歴
Previously Married?
未婚のみ希望 Only someone who has never been married 離婚・死別した理由による Divorced or Widowed 特に気にしない No Preference    
子供
Has Children?
子供がいても構わない Children OK 子供がいる場合は否 No Children 特に気にしない No Preference    
同居義務
Obligation to Live Together
(Perhaps this means together with parents?)
同居可 Can live together 別居希望 Hope to live separately 相談のうえ We'll decide after meeting.    
養子縁組
Plans for Adoption
可能 Possible 不可能 Out of the Question 相談のうえ Decide after meeting.    
「。。。」
???
必要 Necessary 相談のうえ Decide after meeting. 必要なし Not Necessary    
(Personal Details)  
血液型
Blood Type
A型 B型 AB型 O型 不明
Unknown
     
職業
Occupation
無職(家事手伝い含む) Unemployed (includes Homemaker) 会社オーナー・自営 Company Owner / Self-Employed 会社役員 Company Executive 管理職 Management
一般職 General Staff 公務員 Civil Servant 教員 Teacher 医師 Doctor
弁護士・公認会計士 Lawyer / Certified Accountant 自由業 Freelance        
続柄
Birth Order
長男 Eldest Son 次男 2nd Son 三男 3rd Son 四男 4th Son
五男 5th Son 長女 Eldest Daughter 次女 2nd Daughter 三女 3rd Daughter
四女 4th Daughter 五女 5th Daughter        
結婚歴
Marital History
未婚 Unmarried 離婚 Divorced 死別 Widowed    
子供
Children
なし None 一人 One Child 二人 Two Children 三人以上 3 or More Children
健康状態
Physical Condition
極めて良好 Very Good 普通 Average 多少弱い Somewhat Weak    
体型
Body Type
やせ型 Slim ふつう Average 太りぎみ Overweight    
メガネ等
Glasses, etc.
常にメガネ Always Wears Glasses 時々メガネ Sometimes Wears Glasses 常にコンタクト Always Wears Contact Lenses 時々コンタクト Sometimes Wears Contact Lenses
なし None            
飲酒
Alcohol (Intake)
よく飲む I drink often. ほどほどに In Moderation 飲めない I cannot drink alcohol.    
喫煙
Smoking
良く吸う I smoke often. たまに吸う I sometimes smoke. 吸わない I don't smoke.    
同居義務(自分)
Obligation to Live Together (Self)
ある Yes 将来はある Possibly in the Future ない No 相談のうえ Decide after meeting.
同居義務(相手)
Obligation to Live Together (Partner)
同居可 Can live together 別居希望 Hope to live separately 相談のうえ Decide after meeting.    
養子縁組
Plans for Adoption
可能 Possible 不可能 Out of the Question 相談のうえ Decide after meeting.    
「。。。」
????
必要 Necessary 相談のうえ Decide after meeting. 必要なし Not Necessary    
家族構成 (???)
Family Members
Father 母  Mother 祖父 Grandfather 祖母 Grandmother
Older Brother Older Sister Younger Brother Younger Sister
男子 Boy 女子 Girl 叔父 Uncle 叔母 Aunt
甥  Nephew 姪  Niece        
「。。。」
Occupation (or Mother/Father's?)
会社経営・自営 Company Management / Self-Employed 会社役員 Company Executive 会社員 Employee 公務員 Civil Servant
主婦 Homemaker 学生・生徒 Student 無職 Unemployed    
「。。。」
?? (Perhaps status of parents?)
同居 Living Together 別居 Living Separately 死亡 Deceased In Poor Health / Dependent