Submission Form

The database is not public. All contact information and personal details will be kept confidential unless your consent has been given to share it with other members of the database.

Don't be afraid to add some depth and personality to your responses!

General Information

First Name *

Last Name *

Email *

Phone *

Location *

Birthdate *

Height (ft & in) *

Gender *

Photo *

More about you

Sexual Orientation *

Relationship Status *

Occupation *

Jewish Observance *

Kosher *

Describe what your overall Jewish life looks like. *

Do you have children? *

Do you want children/more children? *

Do you drink alcohol? *

Do you smoke? Select all that apply. *

Physical Activity *

Activities/Hobbies I enjoy *

Is there anything else you would like to share about yourself? *

Describe your perfect match

Preferred Gender *

Preferred Sexual Orientation *

Preferred Age Range *

Preferred Jewish Observance *

Preferred Height (ft & in) *

Would you date someone who drinks alcohol? *

Describe your ideal partner *

I agree to receive email communications from Matched x Michelle.

I accept the Terms and Conditions