Membership Questionnaire
Men and women should complete the questionnaire below. Men will be contacted by matchmaker Linda Littman within a week to schedule a consultation. For each of our male clients, women are shortlisted based on the basic information collected below and may be contacted for a brief interview to determine if they may be appropriate for an introduction. There are no matchmaking contracts or introduction fees for female members. You must be at least 21 years of age to participate.

All information provided by you will remain confidential. Inner Circle will not share your information directly with anyone except Inner Circle Social Collective employees to the extent necessary to provide quality matchmaking services. Please complete the Questionnaire below ( All fields are required unless marked 'opt' ). You must agree to our Terms of Service (Click here to review). If you have any questions before completing the questionnaire, please contact us.

If you previously submitted information and would like to be removed from our database, please go to www.cincyinnercircle.com/remove.


Contact/General Information
First Name Last Name
Email
Street Address Apt. No. (opt)
City State Zip Code
Primary Phone #   Best time to reach you (opt)?

Birth Date (mm/dd/yyyy) / / Gender Male Female
Height ft. in. Weight (lbs.)
Marital History If previously married, how many times?
(if never married, enter 0)

Background/Values/Lifestyle

Occupation Annual Income
Education Completed    

Ethnicity
If Other or multiple,
please describe (opt):
What ethnicities are acceptable for potential matches? (Check all that apply)
No Preference Chinese Arab
White Indian Native American
Hispanic Korean Pacific Islander
African-American Japanese Other

Religious Affiliation
If Other or multiple, please describe (opt):
Religious Devotion
Political Views
What religion(s) are acceptable for potential matches? (Check all that apply)
No Preference Hindu
Christian Buddhist
Catholic Spiritual, Not Religious
Protestant Agnostic
Jewish Athiest
Muslim Other

Build/Body Type

How often do you exercise?
What body types/builds are acceptable for potential matches? (Check all that apply)
No Preference Athletic/Fit
Thin Somewhat Overweight
Average Overweight

Have you ever been convicted or charged with a felony?
Do you authorize Inner Circle Social Collective to run a criminal history background check on you (if requested by clientele under contract)?
Note: Answering 'No' will not disqualify your application, but it may prevent you from meeting clientele who request background checks on potential matches.
You will be required to provide official identification information before dating other members. You may enter it here (optional) or you may provide it later if you are offered an introduction and decide to meet.
Driver's License # or State ID # (opt) Issuing State/Agency (opt)

Do you smoke?
Do you drink?
Are you a vegetarian/vegan?
Do you have any pets? Please Describe. (opt)
Is it OK for your match to smoke?
   
Is it OK for your match to drink?

Do you have any children (of any age)?
Number of children living with you (enter 0 if none)?
If you have children living with you, is it part-time or full-time (opt)?
Is it OK for your match to have children living with them?
Aside from any children you or a new partner may already have, would you like to start a new family by having a baby or adopting?
Would you like to get married in the future?

What age range would you be most comfortable with for your matches?   Minimum Age
  Maximum Age

What kind of activities do you enjoy?
In what type of sports/exercise to you participate?
What kind of events to you like to attend/watch?
Please describe what you are looking for in a partner.

How did you hear about Inner Circle?

Pictures (optional, but recommended): Please upload one or two pictures of yourself. These pictures will only be viewed by Inner Circle staff and are not shown to clients or participants under any circumstances. Files must be jpg, jpeg, gif, png, or bmp and can not exceed 2 MB.
First picture (opt):
Second picture (opt):


I have read and agree to the Terms of Service (click for printable version).

Depending on the size of the picture uploads and the speed of your internet connection, it may take a few moments after you click "Submit" to complete the form submission- please wait until you see the confirmation page before closing your browser.

Copyright © 2011 Inner Circle Social Collective, LLC