Email * First Name * Last Name * Gender * --Select-- Man Woman Non-binary Likelihood of Signing Up Likely to Sign Up Not Sure Unlikely to Sign Up Date of Birth Country * --Select-- Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati South Korea North Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela VietNam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe South Sudan Vatican City State (Holy See) State --Select-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming City Street Address 1 Street Address 2 Zip/Postal Code County Language Preference --Select-- Chinese English Afrikaans Albanian Arabic Armenian Azeri Bengali Bulgarian Burmese Cambodian Catalan Chechen Croatian Czech Danish Dutch Egyptian Estonian Farsi (Persian) Finnish French Georgian German Greek Gujarati Georgian Hebrew Hindi Hungarian Icelandic Indonesian Irish Italian Japanese Kannada Kazakh Korean Lithuanian Macedonian Malay Marathi Mongolian Nepalese Norwegian Ouzbek Pashto Polish Portuguese Punjabi Roumanian Russian Serbian Spanish Slovaque Slovene Somali Swedish Swahili Tadjik Tamil Taiwanese Telugu Thai Tibetan Turkish Turkmen Urdu Ukrainian Vietnamese Welsh Zulu Mobile Phone # Alternate Contact Info Availability --Select-- Morning 8am-10am Late Morning 10am-12pm Afternoon 12pm-3pm Late Afternoon 3pm-6pm Evening 6pm-9pm Late Evening 9pm-11pm Weekend only Anytime I am (An Introvert is a 0, and Extrovert is a 10) --Select-- 0 1 2 3 4 5 6 7 8 9 10 About Me (Who I am) Do you have children? --Select-- Yes - living at home full-time Yes - living at home part-time Yes - they are adults No Yes Add Children Age Describe what you are looking for in the person you want to meet Occupation Willing to relocate --Select-- No Yes Relocate Where? Lived Overseas? --Select-- No Yes Country Overseas --Select-- Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati South Korea North Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela VietNam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe South Sudan Vatican City State (Holy See) Ethnicity --Select-- Caucasian African-American Hispanic/Latino Asian Middle Eastern Asian Indian Native American Multi-Ethnic Other Black Chinese Pacific Islander Malay Eurasian East Indian African Religion --Select-- All Agnostic Atheist Buddhist Christian (Catholic) Christian (Protestant) Christian (Other) Hindu Muslim Jewish Pagan & Earth-Based Scientology Taoist Unitarian Universalist Spiritual, not religious Other Free Thinker LDS Animals I Like Allergic To Why are you looking to hire a matchmaker? Are you more old-fashioned? (Man pays, feminine address, Mom raises children) or Modern day? (Pay 50/50 for dinners and nannies for kids) What do you do on the weekends and in your spare time? The five items you can't live without are What are the three things for which you are most thankful? What is the first thing people notice about you? Describe one thing about yourself that only your best friends know Hair Color --Select-- Brown Blonde Red Blue Grey Black Mixed Auburn Salt & Pepper Bald White Other Hair Style --Select-- Bald Very Short Short Medium Long Straight Curly Waivy Funky Height --Select-- Less than 5'ft (Less then 152cm) 5'ft (152-154cm) 5'1"ft (155-156cm) 5'2"ft (157-159cm) 5'3"ft (160-162cm) 5'4"ft (163-164cm) 5'5"ft (165-167cm) 5'6"ft (168-169cm) 5'7"ft (170-172cm) 5'8"ft (173-174cm) 5'9"ft (175-177cm) 5'10"ft (178-179cm) 5'11"ft (180-182cm) 6'ft (183-184cm) 6'1"ft (185-187cm) 6'2"ft (188-190cm) 6'3"ft (191-192cm) 6'4"ft (193-195cm) 6'5"ft (196-197cm) 6'6"ft (198-200cm) 6'7"ft (201-202cm) 6'8"ft (203-205cm) 6'9"ft (206-207cm) 6'10"ft (208-210cm) 6'11"ft (211-212cm) 7'ft (213cm) More than 7'ft (More then 213cm) Weight --Select-- Less than 90lb (Less than 41kg) 90-96lb (41-43kg) 97-102lb (44-46kg) 103-109lb (47-49kg) 110-115lb (50-52kg) 116-122lb (53-55kg) 123-129lb (56-58kg) 130-135lb (59-61kg) 136-142lb (62-64kg) 143-148lb (65-67kg) 149-155lb (68-70kg) 156-162lb (71-73kg) 163-168lb (74-76kg) 169-175lb (77-79kg) 176-181lb (80-82kg) 182-188lb (83-85kg) 189-195lb (86-88kg) 196-201lb (89-91kg) 202-208lb (92-94kg) 209-215lb (95-97kg) 216-221lb (98-100kg) 222-228lb (101-103kg) 229-234lb (104-106kg) 235-241lb (107-109kg) 242-248lb (110-112kg) 249-254lb (113-115kg) 255-261lb (116-118kg) More than 262lb (More than 119kg) Annual Income --Select-- Less than $50,000 $50,001 to $75,000 $75,001 to $100,000 $100,001 to $150,000 $150,001 to $200,000 $200,001 to $250,000 $100,001 to $250,000 $250,001 to $500,000 $500,001 to $1M $1M to $3M More than $3M More than $5M More than $10M More than $15M More than $20M Smoking Habits --Select-- No Light / Social Yes Drinking Habits --Select-- No Light / Social Yes Languages Spoken (fluent) Are your parents still alive? --Select-- No Yes Are your parents still married? --Select-- No Yes If yes, how long have they been married? (Years) What is/was their relationship like? What is/was your mother like? What is/was your father like? What was it like growing up in your home? What is your relationship like with your family? Are you close? In a relationship? --Select-- No Yes Describe your longest relationship The most important relationship Do you like children? --Select-- No Yes Do you want to have children? --Select-- Yes, I definitely want to have Maybe, I am not sure I definitely DO NOT want to have kids Marital Status --Select-- Divorced Separated Widowed Still Married Never Married Single It's Complicated No. of children Any serious medical conditions? --Select-- No Yes Been a patient at mental health facility? --Select-- No Yes Been convicted for crime? --Select-- No Yes If yes to any of above, please explain Interested in Dating Man Woman Non-binary Open Match Age Range from --Select-- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Match Age Range to --Select-- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Match Religion --Select-- All Agnostic Atheist Buddhist Christian (Catholic) Christian (Protestant) Christian (Other) Hindu Muslim Jewish Pagan & Earth-Based Scientology Taoist Unitarian Universalist Spiritual, not religious Other Free Thinker LDS Match Religion Flexibility --Select-- Not Flexible Moderately Flexible Extremely Flexible Match Ethnicity --Select-- All Caucasian African-American Hispanic/Latino Asian Middle Eastern Asian Indian Native American Multi-Ethnic Other Black Chinese Pacific Islander Malay Eurasian East Indian African Match Education Level --Select-- High School Some College Associates Degree Bachelor's Degree Graduate Degree PhD & Above Masters Degree Professional Qualification Diploma Advanced Diploma Polytechnic Junior College & Below A Levels & Below Match Marital Status --Select-- Divorced Separated Widowed Still Married Never Married Single It's Complicated Match Wants to have children? --Select-- Yes, I definitely want to have Maybe, I am not sure I definitely DO NOT want to have kids Match Wants to have children? #2 --Select-- Yes, I definitely want to have Maybe, I am not sure I definitely DO NOT want to have kids Match Smoking Habit --Select-- No Light / Social Yes Match Drinking Habit #2 --Select-- No Light / Social Yes Ideal Height from --Select-- Less than 5'ft (Less then 152cm) 5'ft (152-154cm) 5'1"ft (155-156cm) 5'2"ft (157-159cm) 5'3"ft (160-162cm) 5'4"ft (163-164cm) 5'5"ft (165-167cm) 5'6"ft (168-169cm) 5'7"ft (170-172cm) 5'8"ft (173-174cm) 5'9"ft (175-177cm) 5'10"ft (178-179cm) 5'11"ft (180-182cm) 6'ft (183-184cm) 6'1"ft (185-187cm) 6'2"ft (188-190cm) 6'3"ft (191-192cm) 6'4"ft (193-195cm) 6'5"ft (196-197cm) 6'6"ft (198-200cm) 6'7"ft (201-202cm) 6'8"ft (203-205cm) 6'9"ft (206-207cm) 6'10"ft (208-210cm) 6'11"ft (211-212cm) 7'ft (213cm) More than 7'ft (More then 213cm) Ideal Height to --Select-- Less than 5'ft (Less then 152cm) 5'ft (152-154cm) 5'1"ft (155-156cm) 5'2"ft (157-159cm) 5'3"ft (160-162cm) 5'4"ft (163-164cm) 5'5"ft (165-167cm) 5'6"ft (168-169cm) 5'7"ft (170-172cm) 5'8"ft (173-174cm) 5'9"ft (175-177cm) 5'10"ft (178-179cm) 5'11"ft (180-182cm) 6'ft (183-184cm) 6'1"ft (185-187cm) 6'2"ft (188-190cm) 6'3"ft (191-192cm) 6'4"ft (193-195cm) 6'5"ft (196-197cm) 6'6"ft (198-200cm) 6'7"ft (201-202cm) 6'8"ft (203-205cm) 6'9"ft (206-207cm) 6'10"ft (208-210cm) 6'11"ft (211-212cm) 7'ft (213cm) More than 7'ft (More then 213cm) Ideal Weight #2 from --Select-- Less than 90lb (Less than 41kg) 90-96lb (41-43kg) 97-102lb (44-46kg) 103-109lb (47-49kg) 110-115lb (50-52kg) 116-122lb (53-55kg) 123-129lb (56-58kg) 130-135lb (59-61kg) 136-142lb (62-64kg) 143-148lb (65-67kg) 149-155lb (68-70kg) 156-162lb (71-73kg) 163-168lb (74-76kg) 169-175lb (77-79kg) 176-181lb (80-82kg) 182-188lb (83-85kg) 189-195lb (86-88kg) 196-201lb (89-91kg) 202-208lb (92-94kg) 209-215lb (95-97kg) 216-221lb (98-100kg) 222-228lb (101-103kg) 229-234lb (104-106kg) 235-241lb (107-109kg) 242-248lb (110-112kg) 249-254lb (113-115kg) 255-261lb (116-118kg) More than 262lb (More than 119kg) Ideal Weight #2 to --Select-- Less than 90lb (Less than 41kg) 90-96lb (41-43kg) 97-102lb (44-46kg) 103-109lb (47-49kg) 110-115lb (50-52kg) 116-122lb (53-55kg) 123-129lb (56-58kg) 130-135lb (59-61kg) 136-142lb (62-64kg) 143-148lb (65-67kg) 149-155lb (68-70kg) 156-162lb (71-73kg) 163-168lb (74-76kg) 169-175lb (77-79kg) 176-181lb (80-82kg) 182-188lb (83-85kg) 189-195lb (86-88kg) 196-201lb (89-91kg) 202-208lb (92-94kg) 209-215lb (95-97kg) 216-221lb (98-100kg) 222-228lb (101-103kg) 229-234lb (104-106kg) 235-241lb (107-109kg) 242-248lb (110-112kg) 249-254lb (113-115kg) 255-261lb (116-118kg) More than 262lb (More than 119kg) Match Body Type --Select-- Slender Athletic Average A few extra pounds Large Petite Fit Curvy Match Key Values Match Dealbreakers Distance Willing to Travel Match Annual Income --Select-- Less than $50,000 $50,001 to $75,000 $75,001 to $100,000 $100,001 to $150,000 $150,001 to $200,000 $200,001 to $250,000 $100,001 to $250,000 $250,001 to $500,000 $500,001 to $1M $1M to $3M More than $3M More than $5M More than $10M More than $15M More than $20M Sign Up Nonpaying Member Paying Member Sign Up cannot be empty