Match making form test

Marriage Bureau Standard Registration Card

Islambrella Matchmaking Form

Nationality *

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Status in the US *

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Height *

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ABOUT YOU Ethnicity/Culture (by region) select all that you are open to *

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ABOUT YOU Ethnicity/Culture (by country) choose two if your parents are from different countries *

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Primary Language *

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other langugage

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Other Language *

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Which country did you spend most of your life?

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what’s your preferred social media platform?

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What’s your preferred social media platform?

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What’s your social media handle on the selected platform?

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Marital history about you *

Single/Never Married Divorced no kids Divorced with kids Widowed no kids Widowed with kids Other

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how many years have you been married?

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how many years have you been divorced?

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how many years have you been widow?

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how many

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Age of Children?

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What is your profession? *

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are you student *

Yes No

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What do you study?

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When is your estimated graduation?

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Highest Level of education

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How financially independent are you? *

I don’t earn income right now Somewhat independent Unsure I pay all my expenses I pay my expenses and others depend on me

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How financially comfortable are you? *

Very financially stressed Somewhat stressed Unsure I have some savings I have plenty of savings

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which income range best reflects you?

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How much do YOU expect to contribute to household expenses after marriage? *

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Radio

Yes No

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How much do you expect YOUR PARTNER to contribute to the household expenses after marriage? *

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Are you flexible on this matter? How much do you expect YOUR PARTNER to

Yes No

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Men do you have a range in mind that you would consider to be affordable for Mehr?

Yes No

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Tell us any concerns or comments you have about Mahr

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Women Share any specific Mehr you have in mind remember this will not be shared it is only to rule out candidates

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Women how flexible are you on Mehr? *

Not flexible Somewhat flexible Very flexible Depends on the person

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What is your sect? *

Sunni Shia Other (please specify)

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Other Sect (Please Specifies)

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are you revert *

Yes No

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How long have you been Muslim?

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How present is Islam in your daily life? *

Very little Somewhat Moderate Mostly It is vital

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Eating Halal *

I only eat zabiha halal I only eat halal Flexible I’m not concerned about it

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Hijab Preference *

"(Female) yes, I wear hijab" "(Female) no, I don’t wear hijab" (Male) I prefer hijab (Male) I prefer no hijab (Male) I’m flexible

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Would you be open to a man who would require you to start wearing hijab?

Yes No It Depends

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Keeping a halal lifestyle *

Not at all A little Moderate Mostly All the time

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Eating Halal *

Not at all A little Moderate Mostly All the time

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Praying 5 times a day *

Not at all A little Moderate Mostly All the time

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Fasting during Ramdan *

Not at all A little Moderate Mostly All the time

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Jumua Prayer *

Not at all A little Moderate Mostly All the time

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Zakat / Charity *

Not at all A little Moderate Mostly All the time

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Reading / Listening to the Quran *

Not at all A little Moderate Mostly All the time

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Are you willing to relocate? *

Yes No

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Any restrictions? Are you willing to relocate?

Only Within my state Only Within America I’m flexible Other (please specify)

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Please tell us about your openness to relocation

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Are you open to matching someone outside the USA? *

Yes No

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Do you drink alcohol? LETS GET A LITTLE PERSONAL (keep in mind this info is only used to catch deal breakers, not as apart of a profile sent to potential matches. Please be honest) *

Yes No

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Do you smoke marajuana? *

Yes No

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Do you take drugs of any kind? *

Yes No

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Do you struggle with any substance abuse / addictions? *

Yes No

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Are you currently sexually active? *

Yes No

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Anything personal you want us to know before the consultation? Let us know what’s on your mind.

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Do you eventually want to have children? *

Yes No It depends

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If Yes Do you eventually want to have children? *

Within 2 years of marriage Sometime after 2 years I'm flexible

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Please explain your openness to having children

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What are your thoughts about having or being a stay at home wife? *

I don’t want this at all I don’t prefer it but I’m flexible it depends I definitely want this I have other thoughts on this

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ABOUT YOU Share any thoughts you have on this What are your thoughts about having or being a stay at home wife?

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What are your thoughts about having or being a stay at home mom for your children? *

I don’t want this at all I don’t prefer it but I’m flexible It depends I definitely want this I have other thoughts about this

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ABOUT YOU Share any thoughts you have on this What are your thoughts about having or being a stay at home mom for your children?

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Multi Line

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Describe yourself using three words, and tell us anything you would like us to know about you.

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Now tell us what you're looking for

You’ve completed the majority of this form. Only a few minutes left!

Now we’re going to ask you about your partner preferences.

ABOUT YOUR PARTNER PREFERENCES Sect *

Sunni Shia Other I’m flexible

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Other Sect

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Ethnicity/Culture (by region) select all that you are open to *

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your Ethnicity/Culture (by country) choose two if your parents are from different countries *

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What language is it important for them to be fluent in? *

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Younger than

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Is this number flexible (Age Preference) they must be younger than

Yes No

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Older than

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Is this number flexible (Age Preference) they must be older than

Yes No

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Taller Than

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Is this number flexible Selected Number of Height Preference?

Yes No

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Shorter Than

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Is this number flexible Selected Number of shorterthan?

Yes No

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Are you open to someone who does not want kids?

Yes No It depends

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ABOUT YOUR PARTNER PREFERENCES Which of the following marital history are you open to in your partner? (You can select multiple)

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Are you open to someone who has kids?

Yes No It depends

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I expect my spouse to live with my family in one home

Yes No It depends

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I’m open to living with in laws *

Yes No It depends

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Depends on what? I’m open to living with in laws

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Men do you expect your wife to wear hijab? *

Yes No I’m flexible

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Men will you expect your wife to be a full time home maker at any point? *

Yes No It depends

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depends on what Men will you expect your wife to be a full time home maker at any point?

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Women do you expect your husband to have a beard? *

Yes No I’m flexible

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Women do you have specific Mehr expectations? *

Yes No Haven't thought about it It will depend on my partner

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Ethnicity / culture