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Compatibility-based speed dating sign up
1
Name
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First Name
Last Name
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2
Email
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3
How did you hear about us?
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Instagram
Web search e.g. Google
Friend
Church
Reddit
Email
Other
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Instagram
Web search e.g. Google
Friend
Church
Reddit
Email
Other
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4
Gender
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Male
Female
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5
What kind of relationship are you looking for?
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looking for relationship possibly leading to marriage
looking for friendship
not sure yet
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6
How old are you?
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7
What age range of matches are you open to meeting? Select all that apply.
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22-25
26-29
30-33
34-36
37-40
41-45
46-50
51+
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22-25
26-29
30-33
34-36
37-40
41-45
46-50
51+
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8
What City and State are you based in?
*
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9
Are you open to meeting potential partners outside your state?
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Yes
No
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10
What states are you open to meeting potential partners from? Select all that apply.
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AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Please Select
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
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11
What is your religion? All events will only have participants of the same faith as we believe shared values are key!
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12
What race do you identify as? Select all that apply.
*
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
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13
What are your race preferences in a partner? Select all that apply.
*
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No preference
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Please Select
No preference
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
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14
What is your total annual pre-tax income?
*
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$100k or less
$101 - 150k
$151 - 200k
$200 - 300k
$300 - 500k
$500k+
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15
What is the minimum annual pre-tax income you prefer in a partner?
*
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$100k or less
$101 - 150k
$151 - 200k
$200 - 300k
$300 - 500k
$500k+
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16
What is your highest level of education attained?
*
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Less than high school
High school (or GED)
Some college
Associate degree
Bachelor's degree
Graduate degree e.g., Masters or PhD
Professional degree e.g., MD or JD
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17
What is the minimum level of education you prefer in your partner?
*
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Less than high school
High school (or GED)
Some college
Associate degree
Bachelor's degree
Graduate degree e.g., Masters or PhD
Professional degree e.g., MD or JD
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18
What is your height?
*
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Please Select
<5'0
5'1-5'4
5'4-5'6
5'7-5'9
5'10-6'0
6'1+
Please Select
Please Select
<5'0
5'1-5'4
5'4-5'6
5'7-5'9
5'10-6'0
6'1+
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19
What height ranges are you open to in a partner?
*
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<5'0
5'1-5'4
5'4-5'6
5'7-5'9
5'10-6'0
6'1+
No preference
Please Select
<5'0
5'1-5'4
5'4-5'6
5'7-5'9
5'10-6'0
6'1+
No preference
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20
What other pop up virtual speed dating themes would you be interested in ? Select all that apply.
*
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Age 27 - 35s singles
Age 35 - 45s singles
Over 50s singles
Short kings and queens singles
Tall kings and queens singles
Advanced degree singles (e.g. MD, PhD, MBA, etc.)
Fitness enthusiast singles
Entrepreneur singles
Ambitious singles
Outdoor lovers singles
Single parents
Divorced singles
Immigrant singles
Desi singles
Full-time ministry singles
African & Caribbean singles
Other
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21
What do you think is a fair price to pay for a virtual speed dating event to meet people within your preferences?
*
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$20-$29
$30-$39
$40-$49
$50-59
$60-$69+
$70+
Other
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22
What other speed dating themes would you be interested in attending?
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23
I regularly meet a good number of high quality potential dates / partners
*
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1
2
3
4
5
Disagree
Agree
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24
If you have friends you want to invite to try out our speed dating events please add their emails here (separated by a comma)
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