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Matchmaking Questionnaire
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Matchmaking Questionnaire
Your Name
Your Email
We will not share with potential matches.
Your Phone
Mobile phone number preferred. We may share with your date, once you both agree, for coordination/scheduling.
Facebook Link
Your Birth Year
Example: 1976
Your Sex
Female
Male
Other
I'm interested in dating:
Men
Women
Both Men & Women
Other (Explanation Below)
A brief introduction to who I am:
Tell us about your background, interests, & preferences. HeartFire will keep this info confidential. Example: I'm a college student and plan to become a nurse... I just moved from New York, I play acoustic guitar every day... I have been married twice and have 3 children, ages X, Y, Z... I'm from Australia... I have been vegan for 7 years... I am Jewish but only celebrate the major holidays...
Do you have a child/children?
No.
Yes - they live with me part-time or full-time.
Yes - but they do not live with me. (They live with another parent/caregiver or are adults).
Partner's children-preferences:
I am open to dating people who DO or DO NOT have children. (No strong preference)
I am ONLY open to dating people who DO have children.
I am ONLY open to dating people who DO NOT have children.
"Children" refers to minors under age 18 who live full-time or part-time at home.
Do you live in the Nevada City / Grass Valley / San Juan Ridge / Penn Valley / Auburn area?
Yes, full time.
Yes, seasonally or part-time.
No, but I live nearby (Roseville, Sacramento, Reno, Tahoe, Chico, etc.)
No, I'm just visiting.
