Matchmaking Registration Survey
Please complete this survey to help us find your most compatible match. Your responses will remain confidential.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Female
Male
Non-binary
Prefer not to say
Other
Age
*
What is your relationship goal?
*
Serious relationship
Marriage
Friendship
Casual dating
Not sure/Other
Preferred gender(s) of your match
*
Female
Male
Non-binary
No preference
Preferred age range for your match
*
Rows
Minimum Age
Maximum Age
Preferred Age Range
How important are the following qualities in a partner?
*
Rows
Not important
Somewhat important
Very important
Sense of humor
1
2
3
Ambition
4
5
6
Family values
7
8
9
Physical fitness
10
11
12
Shared hobbies
13
14
15
Emotional intelligence
16
17
18
Lifestyle habits (select all that apply)
Non-smoker
Smoker
Drinks alcohol
Does not drink alcohol
Active/Enjoys exercise
Prefers quiet activities
Other
Rate your interest in the following activities
Rows
Not interested
Somewhat interested
Very interested
Traveling
19
20
21
Cooking
22
23
24
Music/Concerts
25
26
27
Sports/Outdoor activities
28
29
30
Reading
31
32
33
Art/Culture
34
35
36
Please list any dealbreakers or must-have qualities in a partner
Is there anything else you'd like us to know about you or your preferences?
Submit Registration
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