Form
Full Name
*
Age
*
Email
*
example@example.com
Gender
*
Male
Female
Ethnicity
*
Black/African
White
Hispanic/Latino
Asian
Mixed
Other
City & State
*
Phone Number
*
Instagram/TikTok/Facebook
What is your Day Job?
*
Height
*
Do you have any religious beliefs? If yes, what?
*
Christianity, islam…
Do you have kids?
*
Are you open to dating someone outside your race or ethnicity?
*
Yes
Somewhat
No
What is your preferred age range for a potential match? Is this a deal breaker?
*
If you’re comfortable sharing, is there anything we should know about who you feel most compatible with? Is this a deal breaker?
Are you open to dating someone with kids?
*
•Do you have any height preferences for your potential match? If yes, please share. Is this a deal breaker?
*
What do you hope to find on the show(Fun/Light Dating, Serious Relationship, Open to Either)?
*
Are you open to long-distance dating? If yes, how far are you willing to go?
*
Are you open to meeting someone who may not fit all of your usual preferences, or do you prefer to wait for someone who matches them closely?
*
Upload a clear and recent photo of yourself.
*
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