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Potential Participant Survey

To participate in the Axios Blind Date program, you must be over 21, single, and live in Charlotte. By filling out this form, you're agreeing to potentially being photographed/recorded by an Axios reporter and detailing your evening for an upcoming article and/or social post.

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* 1. Are you willing to share a photo of yourself and your first name as part of the series?

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* 2. First and last name

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* 3. Age

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* 4. With which gender identity do you most identify?

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* 5. Which best describes your sexuality?

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* 6. Your height

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* 7. Your job

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* 8. Favorite hobbies/interests?

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* 9. Describe how you’d spend an ideal day in Charlotte:

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* 10. Describe yourself in a sentence.

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* 11. Describe your ideal match in a sentence.

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* 12. Neighborhood/Area you live in

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* 13. Why should we choose you?

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