Name
*
First Name
Last Name
Email
*
Phone
*
The matchmakers will connect with you via text, if we find you a match!
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Zip Code
*
Cities (major metros only) in which you're willing to date?
*
Relationship status you're willing to date
*
Single--Never married
Divorced
Widowed
Separated
Divorce in Progress
Your Top 3 Priorities in a Mate
*
Min and Max age you'll date
*
type in an age bracket (ie 35-45)
Match Ethnicity
*
Who are you wanting to date?
Do you have kids?
*
Do you want kids?
*
Can your match have kids?
*
Employment Status
*
Employee/Contractor
Currently Looking for work
VP/Group Mgr
C-Level Exec
Self-Employed
Retired
Company Name
*
If you on longer work, or are currently looking, please leave blank. Otherwise, please let us know your current employer. This information is for the matchmakers' eyes only.
Job title/Description
*
Your Salary Range
*
Under $40k
$40-60k
$60-80k
$80-100k
$100-150k
$150-200k
$200-500k
$500k-1M
$1M+
LinkedIn Profile
If you have a LinkedIn profile, please give me your URL
Political Preference
Republican
Democrat
Libertarian
Socialist
Communist
Independent
I don't care about politics
Your top 3 deal breakers?
*
Examples: smoking, obese, under 5'5, etc.
What else should we know about you?
*
Anything specific we should know about you?! The more you tell us, the better we can match you! :-)
