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keyoka
2024-11-05T14:21:05+00:00
Application
Application
Ready to Find Your Perfect Someone? Apply With Us Today!
Your
Details
First name
*
Age
*
Occupation
*
Last name
*
Income
*
<$30,000
$30,000 - $50,000
$50,000 - $100,000
$100,000 - $200,000
$200,000+
Your
Match
Income
*
<$30,000
$30,000 - $50,000
$50,000 - $100,000
$100,000 - $200,000
$200,000+
Seeking a
*
Male
Female
Age range your looking to date
*
26 - 30
30 - 39
40 - 49
50 - 59
60 - 69
70 - 79
80+
Contact
Information
Phone
*
Email
*
Zip
*
State
*
Best Time to Contact
*
Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings
How did you
hear about us
Please Select
*
Referral
Social Site
Google
Print
Other
Other
Information
Please Describe Yourself
*
What are you looking for in a significant other
*
Describe your ideal date
*
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