Kiddish Wedding Cup
Mission Possible Marriage Application

* = Required field

Your Information

* Today's Date

* First Name (English)

* Last Name (English)

* First Name (Hebrew)

* Address 1

Address 2

* City

* State

* Postal Code

* Phone

Cell Phone

* Email Address

You may contact me by email

* Birthdate (mm/dd/yy)

* Age

* Gender

* Height

* Eye Color

* Hair Color

* Physique

Marital Status

* What is your current status?

If you were previously married, how many times have you been married?

If you have been divorced, who issued the GET?

* Do you have any children?

If yes, do any of these children live with you?

Please list the ages and gender of the children living with you:

0/300 words

* Do you want to have more children?

Future Plans

* Do you have a preference as to where you want to live after marriage?

If yes, in which city/state/country would you prefer to live?

* Are you flexible about where to live?

Seeking

* What age range would you prefer?

* Are you willing to travel to meet someone?

If yes, under what circumstances, and how far would you travel?

* Would you marry someone who is a Ger Tzedek (Convert)?

* Would you marry someone who is a Baal(as) Teshuva?

* Would you marry someone who has been widowed?

* Would you marry someone who has been divorced?

* Would you marry someone who already has children?

* Would you marry someone with a disability?

* Would you marry someone who smokes?

* What personality traits do you want in a spouse?

0/300 words

* What personality traits do you not want in a spouse?

0/300 words

* Is appearance important?

Personal History

* Where did you grow up?

* Is there anything significant about your childhood that you wish to share?

0/300 words

* Do you have siblings?

If yes, how many?

* Please describe your current relationship with your family:

0/300 words

* Is your mother Jewish by birth?

* Is your father Jewish by birth?

If no, please explain:

0/300 words

* Are you a caretaker of a family member?

Religious Observance

* Please describe your Hashkafa (religious perspective/viewpoint) and Religious Goals.

0/300 words

* Are you involved in or do you belong to any Jewish or chessed organizations?

If yes, which one(s)?

* What are the Primary Synagogue(s) you attend?

* Please list the Rabbi(s) of Synagogue(s), with contact information.

0/300 words

* Are you a Baal(as) Teshuva?

* Are you a convert?

If yes, what year did you convert?

If yes, how many months or years have you been observant? (Shabbos, Kashrus)

Who was the Rabbi or Bet Din who performed the conversion and in what city?

If applicable, what drew you to becoming a Baal(as) Teshuva?

0/300 words

Self Description

* What is your occupation?

* Please describe your life ambitions and aspirations.

0/300 words

* What do you enjoy doing during your leisure time?

0/300 words

* What kind of people or qualities do you admire?

0/300 words

* Defining Middah (personal trait):

0/300 words

* Please give a short description of your personality, talents, interests, etc.

0/300 words

* Do you smoke?

* Is there anything else you would like to tell us about yourself?

0/300 words

References

* Title

* First Name

* Last Name

* Phone

Email Address

Title

First Name

Last Name

Phone

Email Address

Please attach a recent photograph of yourself (not older than 6 months ago).

If you have not completed all required fields, when the form is re-presented with the red error messages, the Photo field will be blank. This is done for security reasons. Please complete required fields and re-enter your photo, then submit. Thank you.

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