Connection Counter with Mindful MatchUp

Connection Counter by Mindful MatchUp

Tell us who you connected with and if you match, we'll help you two see each other again!
Your Full Name*

First NameLast Name
Your Email*
example@example.com
Connection Circumstances*
Date Connection Was Made*

MonthDayYear
Date
Address Connection Was Made At*

Street Address

Street Address (ex: 123 Main St.) or Location Name (ex: YMCA)

CityState

Zip Code
Do you know the name of the person you connected with?*

YesNo
Name of Person You Connected With (first, last, or both are helpful)

First NameLast Name
What are some ways to describe them? What were they wearing, what did they look like?
This will help us figure out who you connected with if you don't remember their name! =)
What were you wearing when you met this person? What do you look like? (This is in case they describe you!)
What are the top 2 qualities of theirs that you are drawn to?

Demeanor (i.e. positive, calm, fun)Energy (i.e. adventurous, playful, ambitious, funny)Emotional Intelligence (i.e. empathetic, accountable, connected)Values (i.e. kind, generous, honest)Personality (i.e. confident, good conversationalist, reciprocal)Gifts (i.e. physically attractive, intelligent, successful)Other
Want to share a statement/compliment about who you met?
Example: "John was a good listener and made me laugh!"
Anything else you'd like to tell us about this connection?
We're excited to help you build authentic connections and relationships!

Look for a confirmation email with the next steps! Hope to see you soon!
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Connection Counter by Mindful MatchUp

We're excited to help you build authentic connections and relationships!