One on One Interview Questionnaire
Let your answers flow! Don't overthink them. Have fun with it. Be bold and brave and share about yourself. (If you have a gmail email address, you can save your work and finish later. If you don't have a gmail account, you need to finish in one sitting.) 
Email *
First and Last Name *
How did you hear about the Seattle Shadchan?
Complete Home Address (City, State, Zip Code) *
Date of Birth *
MM
/
DD
/
YYYY
Cell Phone *
Where did you spend most of your childhood? *
Age *
What age range would you prefer to date? *
Your Height *
Describe your Religious Status: such as Yeshivish, Chabad, Modern Orthodox, Conservadox, etc. *
If divorced: Do you have a get? And are you civilly divorced?
CHILDREN: Do you have children? Ages? Do you want to have children?
How do you feel about marrying someone divorced? Please explain. *
Would you marry someone with children? *
Women- do you want to cover your hair?
Clear selection
Men- do you want a woman who covers her hair?          
Clear selection
Where did you go to school? *
Degrees Received *
Occupation, pertinent past occupations *
What do you like about your current occupation? *
On a scale of 1 to 10, how much do you want to get married? *
On a scale of 1 to 10, how motivated are you to do what it takes to marry within 6-18 months? *
Name 5 things you are thankful for and WHY: (Don't forget the the WHY!) *
Favorite interests and hobbies and/or how do you use your free/relaxation time?
Name 5 things that give you pleasure/make you happy: *
Name 3 things that annoy you: *
Ten adjectives that describe you *
What are you core values? *
What values do you need in a spouse? *
What are your deal breakers? *
Personal Description: Who are you? Don’t be shy!  (Include GOALS and INTERESTS) This is the place that a paragraph would be helpful. *
Looking For: What kind of person do you want to marry? Write what’s necessary for you to connect with your prospective life partner. This is another place where a paragraph would be helpful. Picture your future spouse and describe him/her. *
Shul/Rabbi’s name and phone #
Share a little bit about your parents and siblings and your relationship with them. *
Willing to relocate? *
Willing to date long distance? *
Aliyah? *
Do you have a mental or physical handicap or challenge? (This information will remain confidential and will not be shared without your permission.) *
ON A SCALE OF 1 TO 10, HOW IMPORTANT IS LOOKS? DO YOU HAVE A “LOOK” THAT YOU ARE SET ON? *
DO YOU TAKE CARE OF YOUR HEALTH?  HOW? *
WHAT HAVE YOU LEARNED ABOUT MARRIAGE THROUGH YOUR OWN FAMILY SITUATION? *
WHAT MAKES YOU UNIQUE? WHAT GIFTS/TALENTS HAS HASHEM BLESSED YOU WITH THAT YOU MAKE YOU SPECIAL? (don’t be modest here!) *
WHAT WILL YOU BRING TO YOUR SPOUSE/MARRIAGE? IN WHAT WAYS MIGHT YOU BE A GIVER? *
HOW WOULD YOUR FRIENDS DESCRIBE YOUR PERSONALITY? *
WHAT DO YOU THINK HAS HELD YOU BACK FROM FINDING THE RIGHT PERSON TO MARRY? *
WHAT DO YOU FEEL IS YOUR PURPOSE IN THIS WORLD? *
WHAT KIND OF JEWISH HOME DO YOU ENVISION CREATING? *
WHAT DOES YOUR JUDAISM MEAN TO YOU AND HOW DO YOU EXPRESS IT?
WHAT LEVEL OF JEWISH COMMITMENT DO YOU DESIRE IN A SPOUSE? *
WHAT DOES YOUR MARRIED IDEAL SHABBOS EXPERIENCE LOOK LIKE: *
Anything else you wish to share? *
Would you like to have a One on One Zoom Interview with Matchmaker Laurie? *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy