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Application Form
1
Package applying for
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All-Inclusive-Singles
All-Inclusive-Family
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All-Inclusive-Singles
All-Inclusive-Family
If applying on behalf of a single, please make sure you have their full consent.
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2
Full Name:
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First Name
Last Name
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3
E-mail:
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4
Phone Number
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Area Code
Phone Number
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5
Marital Status
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Never Married Before
Previously Married
Previously Married with children
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Never Married Before
Previously Married
Previously Married with children
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6
Age
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7
Occupation
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8
Educational Level
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High School Diploma
Some College Credit
Associate Degree
Bachelor's Degree
Master's Degree
Doctoral Degree
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High School Diploma
Some College Credit
Associate Degree
Bachelor's Degree
Master's Degree
Doctoral Degree
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9
Religiosity
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Please Select
Very Practicing (do extra worship beyond the obligatory acts)
Practicing (pray 5 times a day and fast)
Somewhat Practicing (pray inconsistently but fast)
Not Practicing (Do not pray or fast)
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Please Select
Very Practicing (do extra worship beyond the obligatory acts)
Practicing (pray 5 times a day and fast)
Somewhat Practicing (pray inconsistently but fast)
Not Practicing (Do not pray or fast)
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10
Please select all the statements that apply :
*
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I don't smoke
I smoke
I don't drink
I drink
I smoke Nargileh
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11
Ethnicity
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12
Height
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13
City/State of Residency
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14
Are you open to other ethnicities?
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Yes
No
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Please Select
Yes
No
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15
What's the maximum Age you would consider?
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16
I am open to considering someone (please select all statements that apply) :
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Never being married before
Previously married
Previously married with one kid
Previously married with more than one kids
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17
If you were to meet your future spouse, what are the 5 most important traits you would like to find ?
*
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Religion
Kindness
Character
Modesty
Respect
Honesty
Wittiness
Bashfulness
Spirituality
Ambition
Passion
Physical fitness
Romance
Extrovert
Introvert
Fun
Energy
Enthusiasm
Determination
Good listener
Spontaneous
Calm
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18
What's the single biggest thing that has been missing in the people you have been meeting?
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19
What unique qualities do you possess that would make us eager to recommend you to our clients?
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20
What are the three most significant turn-offs in a potential spouse?
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21
When considering a potential spouse, which immigration status are you open to? (Please select all that apply)
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U.S. Citizen
Work Visa Holder
Permanent Resident
All Immigration Statuses
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22
Are you willing to relocate?
YES
NO
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23
Legal Status
*
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Please Select
US Citizen
US Green Card
US Work Visa
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US Citizen
US Green Card
US Work Visa
Do not apply if you are on student visa, tourist visa or other temporary visas.
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24
If you selected work visa for the legal status, please provide the name of your visa:
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25
A Reference name and phone number.
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26
Please upload a recent picture.
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27
Where did you hear form us?
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Social Media
Family and Friends
Local Masjid
Google
Others
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Please Select
Social Media
Family and Friends
Local Masjid
Google
Others
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