Please fix the following input errors: dummy First Name * Last Name * Gender * --Select-- Male Female Enter your full name to verify that you have read and agree to all terms in the Application Agreement and Terms of Service.This field cannot be empty Mobile Phone # Email * Date of Birth About Me (Who I am) Match Gender * --Select-- Male Female Both Describe what you are looking for in the person you want to meet My Instagram Handleexample @pattistangerThis field cannot be empty Photo Allowed file-types are gif, jpg, jpeg, pjpeg, png The maximum file size limit is 5 MB Extra Photo #1 Extra Photo #2 Extra Photo #3 Street Address 1 City State --Select-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Country --Select-- Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati South Korea North Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela VietNam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe South Sudan Vatican City State (Holy See) Zip/Postal Code Height --Select-- Less than 5'ft (Less then 152cm) 5'ft (152-154cm) 5'1"ft (155-156cm) 5'2"ft (157-159cm) 5'3"ft (160-162cm) 5'4"ft (163-164cm) 5'5"ft (165-167cm) 5'6"ft (168-169cm) 5'7"ft (170-172cm) 5'8"ft (173-174cm) 5'9"ft (175-177cm) 5'10"ft (178-179cm) 5'11"ft (180-182cm) 6'ft (183-184cm) 6'1"ft (185-187cm) 6'2"ft (188-190cm) 6'3"ft (191-192cm) 6'4"ft (193-195cm) 6'5"ft (196-197cm) 6'6"ft (198-200cm) 6'7"ft (201-202cm) 6'8"ft (203-205cm) 6'9"ft (206-207cm) 6'10"ft (208-210cm) 6'11"ft (211-212cm) 7'ft (213cm) More than 7'ft (More then 213cm) Do you have children? --Select-- Yes - living at home full-time Yes - living at home part-time Yes - they are adults No Yes Hair Color --Select-- Brown Blonde Red Blue Grey Black Mixed Auburn Salt & Pepper Eye Color --Select-- Brown Blue Green Hazel Black Grey Are you interested in being featured as Patti's Pick on the MC website? No Yes Are you interested in being featured as Patti's Pick on the MC website? cannot be empty COVID19: Are you vaccinated, if so, why not? What are your views on the vaccines? Please elaborate.This field cannot be empty How did you hear about us? Who referred you?This field cannot be empty