Deliberate Dating Offerings Waitlist Please complete ALL questions below to be added to the student waitlist. Question Title * 1. First & last name Question Title * 2. Date and time of waitlist entry Question Title * 3. What is your identified gender? Female Male Transgender Question Title * 4. I am looking for my perfect-fit-partner who identifies as... Male Female Either Male OR female (I.e. you are bi-sexual) Transgender Unsure/questioning what works best for me Question Title * 5. What is your current age? Question Title * 6. Which Deliberate Dating offerings are you interested in? (Check all that apply) Deliberate Dating Intro: 5 Keys to Successful Online Romance (1 class) Loving ME First: Deliberate Dating Prep Course (5 classes over 5 weeks) Deliberate Dating Program: 5 Weeks to Successful Online Romance (5 classes over 5 weeks) Question Title * 7. What FORMAT of Deliberate Dating offering are you seeking enrollment in? In-person in Newburyport, MA Online using ZOOM Video calls Either works for me Question Title * 8. FOR 5-WEEK PROGRAMS: If you could "hand-pick" when you would want to attend your 2-hour classes for 5-weeks in a row, what days/times of the week would you choose? (I will use this information to inform my scheduling/planning decisions. Please be specific with 3 options for choices.) Question Title * 9. What are your preferred email and phone number? Thank you for completing this contact survey! I will reach out to you once I schedule my next Deliberate Dating Program to inform you of Open Enrollment. It will then be up to you to secure your paid spot in the program before all seats are filled. Coaching space is limited to 6 students in each 5-week program. Done