Speed Date Questionnaire Form

1
Name
First Name
Last Name
2
Age Range**The next events are designed for Daters between the ages of 30 and up. **
30's age range
50's age range
40's age range
60's age range
3
Email
example@example.com
4
Phone Number
Please enter a valid phone number.
5
“Previous dating experience was like?”***Click the box that fits the description?***
Horrible
Complicated
Still a problem
May spin the block
Wish it didn’t end
6
“Share a brief introduction about yourself.”**Highlight just a few key points that capture who you are. Also, include some fun facts—for example, hobbies, interests, or things you’ve enjoyed such as entertainment. ***
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Ok
Ok
7
“How does your free time look?”**What’s your favorite way to spend a weekend?** (Describe a typical weekend you enjoy.)
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Ok
Ok
8
“What’s your ideal relationship?”**What are you looking for in a partner? ** (Please list a few qualities or traits that are most important to you.)
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Ok
Ok
9
“What are your expectations from this event?”**What would you like see?** (Share your suggestions or recommendations.)
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Ok
Ok
10
Selfie**Please upload a recent picture of yourself. ** (This image is for event purposes only and will not be shared publicly.)
11
**Disclaimer for Speed Dating Event:**

On Purpose Speed Dating – Participation Disclaimer
Thank you for your interest in joining our upcoming events!

Event Format: Two-Part Experience
Meet & Greet – (Free)

Meet & Greet (Free Event)
A relaxed introduction event where the On Purpose team will meet all attendees and assess compatibility for the official Speed Date event.

Official Speed Date Event – Date TBA ($50 Ticket)
Selected participants will be invited to attend. Payment for the Speed Date event will be collected during the Meet & Greet.

Actual Speed Date night Includes multiple mini-dates, heavy appetizers, signature cocktails, curated activities, and a mature crowd (ages 30+).
Guests will be grouped by age range for the best matchmaking experience.

***Confidentiality Notice***
Your personal information and any details shared during the event process will remain private and will only be used to support event matchmaking and communication.
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