Email Address
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Cell Phone
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Full Name
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Address
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City
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State
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Country
Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao North Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis and Futuna Western Sahara Samoa Yemen Zambia Zimbabwe
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Zip Code
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What is your occupation
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What is your education level
---- High school degree Vocational high school degree Some college Associate, bachelor\'s, or master\'s degree Doctoral degree More than one academic degree
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What is your Background
---- Sephardic Ashkenazic Bukharian Syrian Moroccan Yemeni Other
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Religious Level
---- Conservative Conservadox Chassidish Just Jewish Lubavitch Modern Orthodox (liberal) Modern Orthodox (Machmir) Modern Orthodox (Middle of the road) Modern Yeshivish Reform Spiritual but not religious Yeshivish Traditional
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Do you keep Shabbat
---- Yes No
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Do you keep Kosher
---- At Home Outside Fully Kosher I do not keep kosher
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Name of the Synagogue you attend
---- Congregation Beth Shalom – Rego Park, NY Forest Hills Jewish Center – Forest Hills, NY Young Israel of Forest Hills – Forest Hills, NY Chabad of Rego Park – Rego Park, NY Bukharian Jewish Congregation – Rego Park, NY Queens Jewish Center – Kew Gardens Hills, NY Etz Chaim Congregation – Kew Gardens Hills, NY Temple Beth Sholom – Flushing, NY Temple Beth Sholom – Flushing, NY Young Israel of Kew Gardens Hills – Kew Gardens Hills, NY
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Are you Cohen, Levy or Israel
---- Cohen Levy Israel Not sure
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Are you a convert?
---- Yes No
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Were you married before
---- Yes No
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Do you have children
---- Yes No
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Answer 3 questions about yourself
---- Personality / Fun Prompts Values / Relationship Intent Prompts Lifestyle / Daily Life Prompts Story / Specific Scenario Prompts
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Conditional Logic if user is Male then looking for female (select Age preference) / IF user is a Woman then looking for male
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What qualities are most important in partner
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Are you open to different backgrounds
---- Yes No
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Are you willing to relocate
---- Yes No
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