Matchmaker Registration

My Contact Information

(Please read all of the Matchmaker Requirements Below. All matchmakers must abide by these requirements.)
First Name	Last Name	Title
User Name	Password^*	Retype^* Password
User Name is 4 to 12 characters	Password may be 4 to 12 characters and must be different than your screen name

Email^*		Retype email^*
Country		Home Phone # ^**
Work Phone # ^*		Cell Phone # ^*
Street^*		City
State/Region:		*Province^:**
Zip or Postal Code:	(^* For outside US, Israel, Canada and UK only)
^* This information is NOT shown to anyone. ^** This information is only shown to people that you choose to show it to.

My Languages

English	Czech	Finnish	Persian/Farsi	Russian	Spanish
Hebrew	Dutch	French	Italian	Polish	Other
Yiddish	German	Norwegian	Portuguese	Swedish

Cost For service:

Do you charge for your Matchmaking services (either up-front or after a successful match is made)?

Yes

My References

Please supply 2 references of people that you have set up that are not your family members, or people who can attest to your potential ability as a matchmaker (character references). We are interested in established matchmakers as well as those with interest in matchmaking. We will Email your references and once they have emailed us your reference then we will follow-up with phone calls where appropriate.

IF YOU DO NOT HEAR FROM US THEN WE HAVE NOT RECEIVED E-MAILS FROM YOUR 2 REFERENCES.

Reference 1

First name:

Last Name: Title

Country

Phone #

Email:

Re-Enter Email:

When did you
set them up?

Comments:

Reference 2