Open Membership Application Form

First Name *

Last Name *

Email *

Phone *

WhatsApp (if different)

City & Country

Gender *

Sexual Orientation *

Ethnicity *

Nationality *

Languages spoken *

Birthdate *

Relationship Status *

Do you have children? *

Do you want children/more children?

Faith/Religion *

Do you drink alcohol? *

Occupation *

Income *

Highest Education Level Completed *

What is your political affiliation?

Do you have any pet allergies? *

Height (ft & in) *

Body Type

Hair Color

Eye Color

Activities/Hobbies I enjoy *

Do you smoke? *

Preferred Gender *

Describe your ideal partner *

How did you hear about us? *

If friend, family or other, please tell us who referred you

Is there anything else you would like to share about yourself?

Please upload a recent headshot *

JPG, JPEG, PNG/10 MB max

Please upload a recent full-body image *

JPG, JPEG, PNG/10 MB max

**By submitting this form, I confirm that all information provided is accurate and truthful. I certify that I am legally single, over the age of 18, open to date coaching, and willing and able to pursue a mutually respectful personal relationship. I agree to abide by the laws of the United Arab Emirates, and acknowledge that any disputes will be governed by DIFC jurisdiction. I accept the terms outlined in the Dubai Matchmaker™ Privacy Policy and Terms & Conditions available at DubaiMatchmaker.com. I understand that any personal information or profiles shared with me by Dubai Matchmaker™, whether in person or electronically, are to remain strictly confidential. I agree not to share, forward, or discuss such materials with others, contact matches directly, or post any reviews or commentary on social media, forums, or websites. I acknowledge that Open Membership does not guarantee any introductions or matches. I understand that Dubai Matchmaker™ and Eiléen Lee-Connor reserve the right to accept, decline, or cancel any membership or application at any time, for any reason. Lastly, I agree that all fees are non-refundable and non-transferable. I authorize Dubai Matchmaker™ (Trade License #985698) to securely store my details in their confidential database and to receive occasional emails regarding future events and partner offers.

I accept the Terms and Conditions