Please fix the following input errors: dummy Email * How did you hear about us? --Select-- HeartString Stuff for Guys Be Your Own Matchmaker Newspaper Article HER Heart Community Heal You Love You Summit Bergen Record Article New Jersey Singles MeetUp Hunt Ethridge Industry Magazine Speak Serve Grow Healthy Love Show LifePastDivorce.com Dating Headshots Love is a Verb CYACYL Magazine WOR 710 Radio Show DatingSuccessAfter40.com Downtown Magazine Event Event Calendar Facebook Friend Funnewjersey.com Girl Talk & Cocktails Google Google+ Jennifer Castaneda LinkedIn Matchmaker Matchmaking Institute Meadowlands Chamber NAPW Newsletter Newspaper Online Profile Pros Postcard Press Release Radio Recruiter/Scout Ridgewood Chamber Sidewalk Sign Television The Divorce Professionals Twitter YouTube YourTango Website BergenBiz Chamber Event Name of Person Who Referred YouThis field cannot be empty First Name * Last Name * Photo Allowed file-types are gif, jpg, jpeg, pjpeg, png The maximum file size limit is 5 MB Gender * --Select-- Male Female Date of Birth 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) Mobile Phone # Availability --Select-- Morning 8am-10am Late Morning 10am-12pm Afternoon 12pm-3pm Late Afternoon 3pm-6pm Evening 6pm-9pm Late Evening 9pm-11pm Weekend only Anytime Extra Photo #1 Extra Photo #2 Extra Photo #3 Undergraduate School Education Level --Select-- High School Some College Associates Degree Bachelor's Degree Graduate Degree PhD & Above Masters Degree Professional Qualification Diploma Advanced Diploma Polytechnic Junior College & Below A Levels & Below Occupation Annual Income --Select-- Less than $50,000 $50,000 to $75,000 $75,000 to $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $100,000 to $250,000 $250,000 to $500,000 $500,000 to $1M $1M to $3M More than $3M Marital Status --Select-- Divorced Separated Widowed Still Married Never Married Single It's Complicated About Me (Who I am) Describe what you are looking for in the person you want to meet Willing to relocate --Select-- No Yes Relocate Where? Ethnicity --Select-- Caucasian African-American Hispanic/Latino Asian Middle Eastern Asian Indian Native American Multi-Ethnic Other Black Chinese Pacific Islander Malay Eurasian East Indian Religion --Select-- All Agnostic Atheist Buddhist Christian (Catholic) Christian (Protestant) Christian (Other) Hindu Muslim Jewish Pagan & Earth-Based Scientology Taoist Unitarian Universalist Spiritual, not religious Other Free Thinker Politically you are? --Select-- Conservative Liberal Moderate Other 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) Weight --Select-- Less than 90lb (Less than 41kg) 90-96lb (41-43kg) 97-102lb (44-46kg) 103-109lb (47-49kg) 110-115lb (50-52kg) 116-122lb (53-55kg) 123-129lb (56-58kg) 130-135lb (59-61kg) 136-142lb (62-64kg) 143-148lb (65-67kg) 149-155lb (68-70kg) 156-162lb (71-73kg) 163-168lb (74-76kg) 169-175lb (77-79kg) 176-181lb (80-82kg) 182-188lb (83-85kg) 189-195lb (86-88kg) 196-201lb (89-91kg) 202-208lb (92-94kg) 209-215lb (95-97kg) 216-221lb (98-100kg) 222-228lb (101-103kg) 229-234lb (104-106kg) 235-241lb (107-109kg) 242-248lb (110-112kg) 249-254lb (113-115kg) 255-261lb (116-118kg) More than 262lb (More than 119kg) Smoking Habits --Select-- No Light / Social Yes Do you have children? --Select-- Yes - living at home full-time Yes - living at home part-time Yes - they are adults No Yes No. of children Do you have any physical, mental or health problems that may be considered an issue for us to match you?No Yes This field cannot be empty Been a patient at mental health facility? --Select-- No Yes Been convicted for crime? --Select-- No Yes If yes to any of above, please explain Match Gender * --Select-- Male Female Both Match Age Range from --Select-- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Match Age Range to --Select-- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 Match Age Range #2 from --Select-- 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 What is your budget for matchmaking?Please enter a dollar amount?This field cannot be empty I would like to be listed in the Matchmakers' Listing ServiceNo Yes This field cannot be empty What services are you interested in? Candidate Membership Dating & Relationship Coaching DineAt8 (Dinner Club) Matchmaking Online Dating Singles Events Team of Experts This field cannot be empty