Matchmaker Chanelle

This form takes about 10–20 minutes to complete. Please take your time and answer honestly and thoughtfully. Every detail helps us better understand you and the kind of connection you deserve.

Your future soulmate could be on the other side of this form!

General Information

First Name *

Last Name *

Email *

Phone *

Gender *

Birthdate *

Location *

LinkedIn URL: *

Instagram Username/Handle:

What locations are you open to dating? (Please list all cities, nationwide and/or international) *

What is the age range you are open to dating? *

What are your top three non-negotiables in a relationship? *

Referred by *

More About You

What is in your bucket list (destinations, adventures and activities)? *

Relationship Status *

Occupation *

Income *

What is your net worth? (Confidential) *

Are you a homeowner? *

Height (ft & in) *

Body Type *

Hair Color *

Eye Color *

Languages spoken

What is your political affiliation? *

Do you smoke? *

Do you drink alcohol? *

Sports *

Activities/Passions *

Is there anything else you would like to share about yourself?

Ethnicity *

Faith/Religion *

Highest Education Level Completed

Do you have children? *

Do you want children/more children? *

Background

Have you ever been diagnosed with a mental disorder or are you suffering from any addiction issues? *

Do you currently have any bankruptcies, DUI’s, or legal matters that we should be aware of? *

If you are divorced, what year did your divorce become finalized? *

If you are currently separated, please specify if it is a legal separation.

Describe your relationship with your parents. What is something they taught you about relationships? *

Describe Your Perfect Match

Preferred Gender *

Preferred Age Range *

Preferred Height (ft & in) *

Preferred Body Type *

Preferred Hair Color *

Preferred Political Affiliation *

Preferred Faith/Religion *

Preferred Ethnicities *

Preferred Level of Education *

Preferred Income *

Would you date someone who drinks alcohol? *

Would you date someone who smokes? *

Dealbreakers *

Describe your ideal partner *

Photos: Because we are a high-end agency, please upload professional and classy photos of yourself (preferably photos with no glasses on and no other people in the photos).

Main Headshot *

Full Body Picture *

Photo 1 *

Photo 2 *

Photo 3

Ready To Meet Your Match?

Would you be interested in meeting with the VP of Matchmaking to get guaranteed matches every month? *