First Name Last Name Email PhoneGender Male Female Other Height (in feet) Current Weight (kg) Ethnicity Religion Do you practice your religion/spirituality? Yes No Sometimes Can you briefly describe some ways you practice your religion (e.g attend church regularly/ sometimes, have a set time daily for prayers etc) Educational background- Please state your highest level of education Occupation Where do you live? Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please list your professional URL LINK or somewhere we can view you online. (Must include your name and a photo.) Paste LINK below.* (Facebook, Instagram, LinkedIn etc) What are your main reasons for seeking a professional matchmaking service? What are your deal-breakers in a partner? (Things you absolutely DO NOT want in a partner) What are your must haves in a partner? How would you describe your ideal partner's personality and lifestyle? (E.g reserved, outgoing, playful, gentle, adventurous etc. Please be as descriptive as possible How would you describe your personality? (e.g reserved, outgoing, playful, gentle etc). Be as descriptive as possible. What are your hobbies and interests? What do you like to do in your free time? Are you open to dating someone who lives outside of your city or country? Yes No Maybe Are you open to dating someone who is not of your ethnicity/race? Yes No Maybe What is your current relationship status? Single (never married) Divorced Widowed Do you have children? No Yes, 1 Yes, 2 Yes, 3 Yes, 4 or more ( state number) I would like to date someone in their…(Click all that apply.) 20’s 30’s 40’s 50’s 60’s + I am in my... 20’s 30’s 40’s 50’s 60’s + Have you ever worked with a matchmaker? Yes No Sort of... What is your budget for professional matchmaking services?Not Applicable$2500 - $5,000$5,000 - $10,000None of the above, these are out of my budget (State your budget below) What type of matchmaking service are you looking forJoin database- FreeJoin paid membershipPlease note that if you have selected free membership, we will NOT be actively searching for a partner for you. We will only be reaching out if a paid member is interested in your profile. In other words, there are no guaranteed introductions. If you are interested in an active search, please select paid membershipI agree to pay $100 if selected for an interview Yes No (This fee ensures we are only meeting candidates who are serious about this process. This fee will be applied to membership).What are your expectations from a professional matchmaking service? I am ready to begin matchmaking services...(Click all that apply.) Next Week Next Month I'm just curious, but not ready to invest It’s out of my budget, just wanted to see what you offered. Who referred you to us? Or how did you hear about us?* A family, friend, colleague told me about you. Saw your advert on social media Heard a podcast, read an article, saw an interview Other: Upload pictureMax. file size: 1 GB.
