Christian Matchmaking LA Intake Form

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Welcome to our Christian Matchmaking intake form!

Please note that though we respect and value all people, this program has been created specifically to support the matchmaking of opposite-sexed Christians looking to date other Christians in the Los Angeles & surrounding areas.
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By participating in this service you agree to: Respect the privacy of your match(es), refrain from any inappropriate or non-consenting sexual behavior, hold God up to the highest honor throughout the dating process, and provide us with the necessary post-date feedback/status updates. Furthermore, you acknowledge that this program is blind (i.e. will not be able to see candidates in advance) unless upgrading to premium package.* This field is required.
I AgreeI Do Not Agree
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Do you currently live or spend the majority of your time in the greater LA & Orange County area?* This field is required.
I DoI Do Not
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The information provided in this survey will not be sold or replicated to any outside parties. Though we take the utmost efforts in protecting our participants, we do not hold any liability for any misgivings that stem from the matching of individuals through this program. Please take a moment to review our terms and conditions found at http://www.christianmatchmakingla.com/terms-conditions. Do you acknowledge and agree these terms?* This field is required.
YESNO
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I'm sorry but if you are not able to comply with this program, we cannot move forward. Either go back and change your previous response or please exit the application accordingly.
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Unfortunately due to high volume of participants and low volume of staff, we can only matchmake people who are currently residing within the greater LA & OC area. We look forward to matching in more cities as we grow, but unfortunately at this time we cannot accomodate matchmaking if you do not live in this area.
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At CMLA, our goal isn't just to match people, but it's to provide prayer and coaching to put you in the right mindset for pursuing a Christ-centric, committed relationship.

By participating in this program, you actively agree that you will...

1. Be Open-minded

2. Be Intentional

3. Be Respectful

and above all...put God in the center of your relationship.
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Please enter your name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Area Code
Phone Number
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What's your gender?* This field is required.
Male
Female
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Your Age?* This field is required.
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What city or area do you currently live in?
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What is your denomination?
Non-denominational
Anglican
Baptist
Catholic
Eastern Orthodox
Evangelical
Lutheran
Messianic
Methodist
Pentecostal
Presbyterian
Protestant
Seventh Day Adventists
Confused and unsure???
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How best would you define your level of faith?
"spiritual but not religious"
"religious but not active in church"
attend church on major holidays
attend church around once a month
attend church every week
on fire for Jesus!
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What is your status?
Never married
Divorced
Currently separated
Widowed
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Children
I have and wish I could return the ones I've got
I have and am open to having more
Don't have but I want
Don't have and don't want
Don't have and unsure
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Highest Level of Education?
Highschool
Some college
Associate
Bachelors
Post-graduate
Masters
Doctorate
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What's your profession?
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What's your ethnicity?
White or European American
Black or African American
Hispanic
Native American
Asian
Middle Eastern
Indian
Polynesian
Mixed
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What's your height?
4'10
4'11
5'0
5'1
5'2
5'3
5'4
5'5
5'6
5'7
5'8
5'9
5'10
5'11
6'0
6'1
6'2
6'3
6'4
6'5
6'6
6'7
6'8
6'9
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How would you best describe your body type?
Slender
Average
Athletic
Curvy
Jacked
Heavyset
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Income Level?
Less than $40k
$40 - $70k
$70k - $100k
$100k - $130K
$130k - $160k
Greater than $160K
I choose not to disclose
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Why are you looking to join Christian Matchmaking LA?
Huge
Large
Normal
Small
Ok
Ok
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Please upload a photo of youIdeally please send one face shot
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Please upload a second photo of you (optional)If your first photo does not contain a clear image of your face or body, please upload your second photo here
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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How'd you find out about this program?
Facebook Posts
Friend Referral
Instagram
Church Announcement
Other
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Passionate about our vision?

You can also help support our cause in any of the following ways!

Prayer

Taking a moment to forward this link to any other trusted Christian single friends of yours (http://www.christianmatchmakingla.com/intake-form)

Joining our team as a volunteer. If interested, reach out to us at christianmatchmakingla@gmail.com

Matchmaking Tiers

Below are our different tiers for our matchmaking services.

Baseline

Standard

Premium

$35

(one time fee)

$185

(one time fee)

$250/ mo.

(6 month term paid monthly)

30 min video interview with matchmaker
You will ONLY be eligible in our system as a match for other standard or premium members
Access to select online resources & events

One guaranteed match within our system
Feedback and coaching pre and post dates as they occur
30 min video interview with matchmaker
You will continue to be eligible in our system as a match for other standard or premium members
Access to select online resources & events

In the event that we cannot find you a match within a 4 month period, you will have the option to be refunded and will receive complimentary baseline membership.

Unlimited matches (guaranteed minimum 1 match every month)
Targeted scouting in & outside of our system
Exclusive welcome package
Dating app makeover/feedback (optional)
Dedicated feedback and coaching pre and post dates as they occur
45 min video interview with matchmaker
Full access to online resources
Free access to all CMLA hosted events

In the event that we do not find you a match within a one month period, you will have the option to be refunded for the month.

Add Ons

Dating App Makeover	Coaching Sessions	Monthly Coaching
$180	$100 per session	$160 per month
We will work with you to put your best foot forward by helping with profile content curation, along with providing successful strategies for engaging and maintaining online communications. Proven results.	Includes a one hour session with our on staff professional dating coach. You will come out of it with a set of principles to help guide you through your dating journey along with tailored assignments to get you acting on what you've learned.	Includes 2 one hour sessions with our on staff professional dating coach. You will come out of it with a set of principles to help guide you through your dating journey along with tailored assignments to get you acting on what you've learned.

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My Selection* This field is required.
Baseline (simply like to be considered in the system for others)
Standard
Premium
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Shipping Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
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
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
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
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Checkout* This field is required.If you've been sponsored, please provide a coupon code below and bypass the credit card info. IF YOU ENCOUNTER ANY ISSUES ENTERING IN PAYMENT, TRY MINIMIZING YOUR VIEW. If you still encounter issues, make sure to save your form before exiting out and contact our team at christianmatchmakingla@gmail.com to fix.
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ORDER SUMMARY
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CMLA Baseline Intake FeeCovers the cost of application processing and introductory interview.
$35.00Edit
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CMLA Standard TierIntro package that includes baseline membership within it.
$185.00Edit
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