Community Fit Pre-Qualification Form

Help Us Create Your Perfect Evening

This survey helps us curate meaningful connections for the Where Is The Love? Valentine's event. Your responses allow us to understand your uniqueness and help us align you with like-minded individuals who share your values and intentions for healthy relationships.

Full Name *

Email *

Age Range *

21-24
25-29
30-34
35-39
40-45
46+
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Your Current Relationship Status *

Never married

Divorced

Widowed

Separated

Not in a committed relationship

In a committed relationship / engaged/married

Relationship Snapshot

Are you currently open to: (Select all that apply) *

Long-term partnership

Dating and seeing what unfolds

New friendships and community

Do you have children? *

Yes

No

Are you open to dating someone with children? *

Yes

No

In a few words, describe your ideal next relationship. *

What are your top 3 non-negotiables in a relationship? *

Which 3 values matter most in a partner? (Select 3) *

Honesty

Faith

Ambition

Kindness

Family-oriented

Fun/Playful

Growth-minded

Final Consent

If accepted, I commit to showing up with: *

Integrity in my words and actions

Confidentiality about what shared inn this space

A genuine desure to grow and build WITH others (not just take from them).

Respect for boundaries, time, and diverse perspectives

I agree and commit

I do NOT agree or commit

I understand that:

Completion of this form does not guarantee acceptance.

The community curator will review your responses for alignment.

You will receive a response within 48–72 hours of submission.

This process is about fit, not worthiness, favoritism, or bias.

I Understand

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