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Welcome
Brought to you by: Dating Mechanics
36
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1
Full Name
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First Name
Last Name
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2
E-mail
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3
Age
*
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4
Phone Number (include area code)
Area Code
Phone Number
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5
Gender
*
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I identify as:
Female
Male
Nonbinary
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6
I am a:
*
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Male looking for a Female
Male looking for a Male
Female looking for a Male
Female looking for a Female
I am Bisexual
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7
Ethnic Background (check all that apply)
Asian
Black/African American
Hawaiian
Hispanic/Latino/Spanish
Native American
Middle Eastern
White/Caucasian
other
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8
Do you have small child/ren who need childcare?
This allows us to tailor events to single parents
YES
NO
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9
Relationship History
*
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SINGLE/NEVER BEEN MARRIED
SEPERATED
DIVORCED
WIDOWED
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10
Are you a pet lover? (You can choose multiple)
*
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Dogs
Cats
Reptiles
Birds
No pets
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11
Education (highest level completed)
*
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High School
Some College
Associates/Technical Degree
Bachelors
Graduate or Professional
PHD
Other
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12
Military Experience
*
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Currently Serving/Reserves
Retired Military
No Military Experience
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13
Profession/Occupation
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14
Religious Affiliation
*
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Agnostic
Atheist
Buddhist
Christian
Hindu
Jewish
Muslim
Other
No religious affiliations
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15
My Current Income
under $25,000
$25,000-$50,000
$50,000-$75,000
$75,000-100,000
$100,000 or more
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16
I like to smoke (check all that apply)
*
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Cigars
Cigarettes
Weed
None
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17
I Drink....
Moderately (1-3 throghout the week)
Socially (gatherings & events)
Heavy (frequently in large quantities)
I don't drink at all
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18
How would you describe your appearence?
*
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Check as many as you like to desribe yourself
Slender
Athletic
Fluffy
Stocky
Heavyset
Curvaceous
Full figured
Average
Petite
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19
How often do you date?
Once a week
Two or more times a week
Once or twice a month
Hardly ever
Just returning back to dating
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20
Why are you dating
*
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To find a lifelong partner
To have a friend/companion with sexual attachment
To have a friend/companion with no sexual attachment
To get my feet wet and see what is out there
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21
Age range of someone you are willing to consider dating
*
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20-30
30-40
40-50
50-60
60 and over
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22
Ethnic backgrounds you will consider (check all that apply)
*
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Asian
Black/African American
Hispanic/Latino/Spanish
Hawaiian
Indian
Middle Eastern
White/Caucasian
Other
No preference
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23
Would you date someone with school aged children?
*
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YES
NO
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24
Would you consider dating someone who wanted kids in the future?
*
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YES
NO
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25
What is your preferred relationship history? (check all that apply)
*
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SINGLE/NEVER BEEN MARRIED
DIVORCED
WIDOWED
NO PREFERENCE
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26
What levels of education are you willing to consider?
*
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High School
Some College
Associates/Technical Degree
Bachelors
PHD
No Preference
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27
What religious affiliations are you willing to consider?
*
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Agnostic
Atheist
Buddhist
Christian
Hindu
Jewish
Muslim
Other
No preference
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28
I would date someone who smokes...(check all that apply)
*
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Cigars
Cigarettes
Weed
None
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29
I want to date someone who drinks...
*
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Moderate Drinker (1-3 throghout the week)
Social Drinkers (gatherings & events)
Heavy Drinker (frequently in large quantities)
Not at all
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30
What body type are you attracted to? (check all that apply)
*
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Slender
Athletic
Fluffy
Heavyset
Curvaceous
Full figured
Average
No preference
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31
What would you like a potential date to know about you?
*
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32
Tell us about the type of relationship you seek
*
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33
What activities interest you? (choose as many as you like)
*
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Golf
Wine Tasting
Team Sports (baseball etc.)
Chess/board games
Pool
Bowling
Trivia
Scavenger Hunt
Themed Parties (Black/White Ball, 90's)
Sailing
Museums
Skating
Water/Jet Ski
Skiing/Tubing
Yoga/Kick Boxing/Exercise
Biking
Poetry Night
Volunteering
Cooking Class
Cigar Bar
Hiking
Art Shows
Seminars/Workshops
Dancing
Shooting Range
Speed Dating
Weekend Trips
Jazz Clubs
Paint/Art Parties
Conversation Party/Mixer
None
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34
What are your hobbies and interest we did not list?
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35
We use text to deliver event details (We will not spam you)
*
This field is required.
This is a great way to know the singles events The Dating Mechanic is hosting.
Yes, I would lke to be included in event text
No, I do not want to get event details
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36
Follow The Dating Mechanic for dating tips and intellectual conversation.
*Note* With your submission you consent to receiving emails from Dating Mechanics LLC. & The Dating Mechanic.
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