Exclusive Membership form Basic DetailsDating segments(Required) Rising Adults (20-30’s) HIV-positive Second chance (Divorcees) 45 years plus Christian & faith based Cultural & traditional Professional & Executive Which dating groups do you want to be included inName(Required) Nickname First name Last Email(Required) Your email address Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone number(Required)WhatsApp number(Required)About YouAge(Required)Please enter a number from 18 to 65.Your ageTell us about yourself(Required)(In your own words) Write a few words about yourself. Write about your personality, temperament or how your friends would describe you. What do other people love about you?What do you think people don't know about you(Required)(In your own words) Write a few words about what you think people don’t know about youDeal Breakers(Required)What are your Deal Breakers in relationshipsRelationship status(Required) Single Divorced Widowed It’s Complicated What’s your current relationship status Gender(Required) Male Female Your Gender Complexion(Required) Light skinned Light brown Medium brown (Caramel/ golden) Dark brown Very dark (Deep chocolate) Date of Birth(Required) MM slash DD slash YYYY When were you bornChildren(Required) Don’t have children Have children (Live with me) Have children (Live with me sometimes) Have children (Not live with me) Number of Children(Required) Not applicable for me 1 2 3 4 5+ Like to have children(Required) Yes No Religion(Required)African Traditional BeliefsChristian (Pentecostal/ Charismatic)Christian (Mainline)African Traditional Mix + ChristianIslamSpiritual but not ReligiousAtheist/ SecularOther World ReligionsHome Language(Required)EnglishAfrikaansIsiNdebeleIsiXhosaIsiZuluSesotho sa LeboaSesothoSetswanaSiSwatiTshivendaXitsongaPortugueseOtherOther Languages(Required) English Afrikaans IsiNdebele IsiXhosa IsiZulu Sesotho sa Leboa Setswana Sesotho SiSwati Xitsonga Tshivenda Portuguese Ethnicity(Required)Black/AfricanColouredMixedBody Type(Required)Slim/ SlenderAthletic/ FitAverageCurvyFull figuredPlus sizeMuscular/ TonedBig & BeautifulHeight(Required)Hair colour(Required)BlackBrownRedDyed/ changing colours oftenBaldShavedWhiteGreyOtherEducation(Required) School (Without matric) School (With matric) Trade/ technical College/ university Advanced degree Employment(Required) Currently unemployed Employed Self-employed What’s your employment statusOccupation(Required)State non applicable if unemployed Income(Required) Struggling Solvent Average Comfortable Wealthy Eating Habits(Required) I eat most things I eat healthily I’m a vegetarian I’m a vegan Smoking(Required) I’m a non smoker I Smoke I Smoke occasionally I’m a chain smoker Drinking(Required) I don’t drink I drink socially Yes please Do you have tattoos(Required) I don’t have any Only cosmetically I have a few I have several Many tattoos Do you have piercings(Required) I don’t have any I only have piercing in my ears I have a few(Beyond my ears) I have several I have many, still considering more Disabilities(Required) I have none I have chronic illness or condition I have cognitive or learning disability I have hearing impairment (Deaf/ partially) I have a mental condition I have mobility impairment (Wheelchair or difficultywalking) I have speech impairment I have terminal illness I have visually impairment (Permanent or partially) DisabilitiesWrite a few words about your disability, leave blank if you have no disability Your ideal matchGender(Required)MaleFemaleWhich gender are you interested in Age(Required)Please enter a number from 18 to 65.Ideal Match: (In your own words)(Required)Describe the traits of the ideal person you would like to meet in a few words.What Do You Notice First In A Partner(Required) Smile/ teeth Eyes Skin/ complexion Body type/shape Height Style/ dress sense Voice/ how they speak Confidence/ presence Hair/ grooming Hands/ feet Sense of humour Ambition/ drive Body Type (First Choice)(Required) Slim/ Slender Athletic/ fit Average Curvy Full figured Plus size Muscular/ toned Big & beautiful Body Type (Secondary Choices)(Required) Slim/ Slender Athletic/ fit Average Curvy Full figured Plus size Muscular/ toned Big & beautiful Religion(Required) Christian (Mainline) Christian (Pentecostal/ Charismatic African Traditional Beliefs Christian + Traditional mix Islam Spiritual but not religious Atheist/ Secular Other World Religions Smoking(Required) Non smoker Smoker Occasional smoker Chain smoker Children(Required) Have Children Don’t have children With or without children Eating Habits(Required) Eat most things Eat healthily Vegetarian Vegan Number of Children(Required) No Children 1 child 2 children 3 children 4 children 5+ children Tattoos(Required) Don’t have tattoos Only cosmetic I don’t mind a few I don’t mind several I love tattoos Like to have children(Required) Yes No Complexion(Required) Light skinned Light brown Medium brown (Caramel/ golden) Dark brown Very dark brown (Deep chocolate) Home languages(Required) English Afrikaans IsiNdebele IsiXhosa IsiZulu Sesotho sa Leboa Setswana Sesotho Tshivenda Xitsonga Portuguese SiSwati Piercings(Required) No piercings Only earrings I don’t mind a few (Beyond earrings) I don’t mind several piercings I love piercings Education(Required) School (Without matric) School (With matric) Trade/ Technical College/ university Advanced degree Income(Required) Struggling Solvent Average Comfortable Wealthy Are you open to dating people with disabilities(Required) Yes No Close-Up picture(Required)Accepted file types: jpg, gif, png, Max. file size: 512 MB.Medium shot picture(Required)Accepted file types: jpg, gif, png, Max. file size: 512 MB.Long/full shot picture(Required)Accepted file types: jpg, gif, png, Max. file size: 512 MB.Extra pictureAccepted file types: jpg, gif, png, Max. file size: 512 MB.One more picturesAccepted file types: jpg, gif, png, Max. file size: 512 MB.Consent(Required) I consent to my personal information and photos being stored securely for matchmaking purposes. I agree that my data may be reviewed by the matchmaking team and potential matches. I understand that my information will not be sold or shared outside of this service. I confirm that all details I provide are accurate and truthful to the best of my knowledge. Please note: Your application will only be submitted once your payment has been successfully completed via Yoco. If you exit before payment, your application will not be saved or reviewed. Tick this box if you agree and give consent