Love Seeker Questionnaire Hitting ENTER/RETURN will submit the form. Use pointer to advance through questions. Name * First Name Last Name Email * Phone (###) ### #### What is your current relationship status? Single In a relationship Married Separated Divorced Widowed What are your relationship goals? (Check all that apply.) Marriage/Live-In partner Monogamy Casual dating/companionship Ethical non-monogamy/polyamory Long-distance/Occasional Other What is your gender identity? What are your pronouns? What is your sexual identity? What gender/genders are you interested in? What is your age? * 21-25 26-30 31-40 41-50 51-60 61-70 71-80 81+ What age range will you date? 21-25 26-30 31-40 41-50 51-60 61-70 71-80 81+ What do you do for a living? What is your annual income range? 0-$49,999 $50,000-$99,999 $99,999-199,999 $200,000+ What is your education level? Did not graduate highschool (school of hard knocks) Highschool graduate or equivalent Some college/no degree Associates/vocational training Bachelor's degree Master's degree Doctorate Professional degree Other Are you religious/spiritual? Religious Spiritual Both Neither How important is your partner's religion/religiosity to you? Very important Slightly important Not important What is your religion (if any)? What qualities are most important to you? (Check all that apply.) Kindness Sense of humor Intelligence Physical attractiveness Ambition Honesty Creativity Commitment to family Passion Reliability Other What are some of your hobbies/interests? Do you care if your potential partner has children or wants children? (Explain.) What are your deal breakers? What are your political leanings? Left Centrist/Independent Right Other How important is it that your partners share your political leanings? Extremely important Somewhat important Not important Are you an introvert or extrovert? Introvert Extroverted introvert Introverted extrovert Extrovert Other Would you prefer your partner lean towards introverted or extroverted? Introverted Extroverted No preference Other How do you show and like to receive affection (love language)? (Select all that apply.) Words of affirmation Quality time Physical touch Acts of service Gifts Other What is your activity/energy level? Low Medium High Other Briefly describe a good "normal" day with your partner. Briefly describe a fun date with your partner. Briefly describe your ideal vacation with your partner. Most importantly - what do you think you bring to a relationship? Anything else you think we should know? Please provide 2-3 references (names and emails): Thank you!
