Profile Form for Dinner Match

Dinner-Match Profiles
A civilized way to meet other singles, make new friends, and date!

Thank you for your interest in Dinner-Match.
This information is only used by and seen by the staff matching singles for dinner. It is never published, revealed to other singles, or shared with another entity. If you need it, further information about Dinner-March is here.
Please provide the following information:

First Name

Last Name

Select Gender

City

Zip Code Home

Zip Code Work

Contact Phone
Number where Dinner-Match can best reach you

Email

Marital Status Never Married

Divorced

Widowed

Separated

Year of Birth

Height

Weight

How many children
do you have?

Number of children under 15?

Occupation

Education

Highlight the one which
best describes your diet

Check up to 6 activities below you MOST enjoy on
a regular basis. Do not check more than 6. Choose carefully because if you check more than 6, the computer will only register the first 6 checked.

Animals

Board/Card Games

Computer

Cooking

Creative Activities

Cultural Activities

Dancing

Dining

Events/Festivals

Family/Home

Hunting/Fishing

Movies/Video/TV

Music

Outdoors/Nature

Reading

Sports: Active

Sports: Spectator

Travel

How often, what, and
where
do you smoke?

How and how often
do you exercise?

Check the areas where you might attend dinners. There are four general areas now, maybe more to come later. Addison/N Dallas/Plano
Arlington/Fort Worth
Greenville Av/McKinney/E Dallas
Irving/Grapevine/Mid-Cities
Any Area of DFW

Is there anything else
you would like to add?

Recommend your favorite restaurants below--those you feel are suitable for Dinner-Match. Please give us a phone number or address, too, so we can find the restaurant. Thanks!

Restaurant Favorites

By submitting this form you hereby release and hold Heart Express and SOLO for Singles, their owners, agents, and employees harmless from any and all claims and damages, whether it be caused by myself, by any other person, or by the ordinary negligence of Heart Express, SOLO for Singles, their owners, agents, or employees. If you do agree to the above, please use submit button below.

After submitting, click here to register for next dinner.

Home Dinner-Match
Home Heart Express

First Name
Last Name
Select Gender
City
Zip Code Home
Zip Code Work
Contact Phone Number where Dinner-Match can best reach you
Email
Marital Status	Never Married
	Divorced
	Widowed
	Separated
Year of Birth
Height
Weight
How many children do you have?
Number of children under 15?
Occupation
Education
Highlight the one which best describes your diet
Check up to 6 activities below you MOST enjoy on a regular basis. Do not check more than 6. Choose carefully because if you check more than 6, the computer will only register the first 6 checked.
	Animals
	Board/Card Games
	Computer
	Cooking
	Creative Activities
	Cultural Activities
	Dancing
	Dining
	Events/Festivals
	Family/Home
	Hunting/Fishing
	Movies/Video/TV
	Music
	Outdoors/Nature
	Reading
	Sports: Active
	Sports: Spectator
	Travel
How often, what, and where do you smoke?
How and how often do you exercise?
Check the areas where you might attend dinners. There are four general areas now, maybe more to come later.	Addison/N Dallas/Plano Arlington/Fort Worth Greenville Av/McKinney/E Dallas Irving/Grapevine/Mid-Cities Any Area of DFW
Is there anything else you would like to add?
Recommend your favorite restaurants below--those you feel are suitable for Dinner-Match. Please give us a phone number or address, too, so we can find the restaurant. Thanks!
Restaurant Favorites
By submitting this form you hereby release and hold Heart Express and SOLO for Singles, their owners, agents, and employees harmless from any and all claims and damages, whether it be caused by myself, by any other person, or by the ordinary negligence of Heart Express, SOLO for Singles, their owners, agents, or employees. If you do agree to the above, please use submit button below.