Atlanta Matchmaking (Beth Friedman, Jenna Shulman, Diana Margolis)
This is a confidential form that will not be shared with anyone other than the juLuv matchmakers.
Last Name *
Your answer
First Name *
Your answer
I am: *
I am interested in meeting people who are: *
How old are you? *
Your answer
What is your full birthdate INCLUDING year? Fill out using this formula 3/13/79 *
Please note that this is important to have so that we know when people turn a new age
Your answer
What is your current marital status? *
Age range desired *
Your answer
Have you ever been married? *
How many children do you have? *
If you do have children, please describe:
i.e. their ages, do they live with you, etc.
Your answer
Do you want to have (more) children? *
Are you willing to date someone with children? *
Your answer
Are you willing to relocate? *
How do you best describe your political views (check all that apply)?
Your height *
Please best describe your body type based on the following descriptions (select any/all that apply): *
Required
What would make this a success for you? *
i.e. marriage, date, long-term relationship, etc.
Your answer
Part of town that you live in... *
Your answer
Where are you from...where did you grow up? *
Your answer
Level of Judaism that you currently practice: *
If you have a synagogue affiliation, please list here (this helps us understand who you may/may not already know):
Your answer
Other stuff related to religion: *
i.e. Do you keep kosher (if yes, please explain the extent)? Do you enjoy going to synagogue? Never go? High Holidays only? Take any Jewish classes? Involved in Jewish Community? Shomer Shabbas? Etc?
Your answer
Thoughts on Pets: *
If YES, what type of pet(s) do you currently have?
Your answer
Your profession: *
Your answer
Your Alcohol Consumption Habits: *
Are you a cigarette smoker? *
Are you a pot smoker? *
Some of your hobbies or interests: *
Your answer
Food Schtick (check all that apply) *
Required
Any medical conditions that might help to be aware of? *
Your answer
3 adjectives that describe you * truthfully! *
Your answer
What are your major dealbreakers in a potential match?
Your answer
Any additional info you'd like us to know?
Your answer
In terms of dating typically try to meet people through: *
Required
Are you interested in referrals to any of the following specialists (check all that apply)? *
Required
I am interested in the possibility of being a *
(choose the one that applies best)
Are you on Facebook? *
Who referred you to this service? *
i.e. a person's name or if you heard about it yourself, you can write "self-referred" - please do not just write "my sister" because we often do not know who that is
Your answer
Your Email Address: *
Your answer
Your Cell Phone Number: *
Your answer
I acknowledge that you may use my email address to contact me about this service or to send me relevant dating articles, tips, etc.
Terms of Service *
I understand that I am solely responsible for my interactions with anyone that I am matched with and that this service does not currently conduct criminal background checks or screenings on the members in its database. This service makes no representations or warranties as to the conduct of members or their compatibility with any current or future members. In no event shall this service be liable (directly or indirectly) for any losses or damages whatsoever arising out of or relating to the conduct of you or anyone else in connection with the use of this service.
Required
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Pay it Forward - If you are interested in supporting our efforts and helping this service thrive and grow, please refer us to other singles you may know.

For more info, including all of "The Rules" and FAQ, visit www.juluv.com.
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