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Personal Information

First Name:

Date of birth

Day:

Month:

Year:

Email Address:

Cell Phone:

What messaging app do you use on your phone? SMS WhatsApp Other:

Your Gender:

Woman Man Other:

Personal Status

Single Separated Widowed Other: Married * Partnered *

Children?

Yes No

Your Location:

State:

City:

Neighborhood:

Zip Code:

LinkedIn:

Facebook:

Instagram:

TikTok:

YouTube:

Other:

Profession: (Select all that apply)

Academia (Professor, Researcher, etc.) Education (Teacher, Administrator, etc.) Healthcare (Doctor, Nurse, Therapist, etc.) Technology (Software Engineer, Data Scientist, etc.) Business and Finance (Analyst, Manager, Entrepreneur, etc.) Creative Industries (Artist, Designer, Writer, Musician, etc.) Hospitality (Chef, Bartender, Server, etc.) Non-profit/Social Services

Be specific:

Other:

Education:

High School Associate's degree Bachelor's degree Master's degree / higher Other:

Languages:

What languages do you speak fluently other than English?

Community Preferences:

Are there any specific communities or groups you'd feel most comfortable connecting with?

My own gender My own congregation? Other:

Chatting with new people is:

Very easy for me Easy for me Somewhat easy for me Somewhat challenging for me Challenging for me

I can easily make other people laugh

Very easy for me Easy for me Somewhat easy for me Somewhat challenging for me Challenging for me

Interests: (Select up to 5)

Life Experiences: (Select up to 3)

Significant life transitions (e.g., moving to a new city, career change, major life event) Involvement in social or political activism Creative pursuits or artistic endeavors Entrepreneurship or leadership roles Extensive travel or cultural immersion Other:

Dietary Restrictions and Allergies:

Do you have any dietary restrictions? (Check all that apply)

Vegan Vegetarian Gluten-free Dairy-free Kosher Halal

If you have dietary restrictions, may we match you with non-restricted groups?

Yes No

Do you have any food allergies? (Check all that apply)

Nut allergy Seafood allergy Dairy allergy Other:

Upload Your Photo:

Social Media and Photos:

We encourage you to share photos from the event on social media! Tag us and use #FridayEveningClub so we can see all the fun.

I agree that I should be included in photos and videos.
I prefer not to be included in photos and videos.

Agreements:

I have read and agree to the Terms of Service, Membership Agreement, Privacy Policy, and Code of Conduct.

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