CoronaCrush Virtual Speed Dating
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Complete this form to be invited to future events.
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None of the information you provide will be shared externally.
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This form takes 3 minutes to complete.
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What's your first and last name?
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What's your email address?
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Make sure you input your email address correctly!
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Please confirm your email address:
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What's your cell phone number?
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What's your gender?
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Male
Female
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What gender are you seeking?
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Male
Female
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What's your date of birth?
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Please confirm your age:
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What's the youngest age you'd be willing to date?
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What's the oldest age you'd be willing to date?
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Your parents are:
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Both Jewish
Mom's Jewish, Dad isn't
Dad's Jewish, Mom isn't
Not Jewish
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Where do you live?
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Argentina
Australia
Austria
Belgium
Brazil
Canada
Chile
Colombia
Costa Rica
Croatia
Denmark
Ecuador
Estonia
Finland
France
Germany
Gibraltar
Greece
Guatemala
Hungary
India
Ireland
Israel
Italy
Jamaica
Latvia
Lithuania
Luxembourg
Malaysia
Mexico
Monaco
Netherlands
Panama
Peru
Philippines
Poland
Portugal
Romania
Russia
Singapore
Slovakia
South Africa
Spain
Sweden
Switzerland
Trinidad and Tobago
Turkey
Ukraine
United Kingdom
United States
Uruguay
Venezuela
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Which state?
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (U.S.)
Virginia
Washingon D.C.
Washington
West Virginia
Wisconsin
Wyoming
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Which city? (select nearest city)
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If you live near a big city that isn't in the list, please let us know!
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What language(s) do you speak?
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English
French
Spanish
German
Russian
Italian
Portuguese
Hungarian
Dutch
Hebrew
Arabic
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Are you open to a long distance relationship?
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Yes, love knows no distance!
Yes, as long as they live in the same country
Yes, as long as they live in the same region
No, same state only
No, same city only
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Do you keep Shabbat?
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Yes, strictly
Yes, with some exceptions
Yes, traditionally
Yes, in my own way
No, not at all
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I'm open to date someone who keeps Shabbat: (select that apply)
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Strictly
With some exceptions
Traditionally
In my own way
Not at all
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Do you keep Kosher?
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Yes, strictly
Yes, with some exceptions
Yes, the basics
No, not at all
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I'm open to date someone who keeps Kosher: (select all that apply)
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Strictly
With some exceptions
The basics
Not at all
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Do you give CoronaCrush and DateNight.AI permission to use the data provided for matchmaking purposes?
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Yes
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