Jewish Singles & Shalom Questionnaire

THE SHIDDUCH & SHALOM SUCCESS QUESTIONNAIRE

Many Hours Were Put into Formulating this Questionnaire to Allow Singles to Target what is important to them and to Help them overcome some of the ‘roadblocks’ they encounter and to avoid pitfalls in dating to have a fruitful marriage. We Culled from Torah Sources, Marriage Surveys & Statistics, Psychological Studies, Personality Tests and Experience to formulate it. Filling out the Questionnaire – would probably take about 45 Minutes. These may be the most productive 45 minutes you can have in prepring for Shidduchim – because you will clarify your objectives and know which questions to ask references.

A Copy of Your Answers will be emailed to you to be able to help create or improve your Shidduch resume & To help you know what criteria are important to ask for when searching for a mate and which questions to ask references of potential mates to do your due diligence.

Even if you do not fill-out the questionnaire – it can be printed to give you guidance in your search or to find out what you are willing to improve to obtain a better mate. We suggest that before a person gets married – they should reinforce themselves in Torah & Mitzvot. For Hash-m will match a person according to their general spiritual level. The Higher one is Spiritually – the greater a person they will be matched with.

The GOAL of the questionnaire is Three-fold :
1) To Help Singles to Determine what is Important for you in Marriage.
2) To Help us find a suitable match for you.
3) To Help Married Couples Pinpoint How to Improve their Marriages

Please Fill Out the Following Form to the Best of Your Ability. Check as many checkboxes that apply. Please be as Honest as possible for it will have consequences upon your selection of your mate.

The More information you fill out, the more likely you will be matched with a potential mate.

Information regarding you will not be shared unless you give express permission.

We intend to give the ability to edit and search the Database in the future. In the meantime, we will be the only ones that will be able to view the information.

When Search Function will be in operation in Future, Even the search for a particular type of mate will be anonymous. You will be able to see potential mate’s id numbers. We will determine if they are a good match and contact the party you found to determine if they are available or interested in a date.

There are two types of questions on form – one about yourself. One about the type of mate you would want or accept. When it is a mate question – You should answer the question “What Kind of Mate Would you want or accept to marry?”

You Will Be given the choice of with whom you want your information may be shared.

Please Be Thorough and Check All that Apply. If a Question may seem to be intrusive – the reason is some people in Torah are forbidden to Marry others – so we will not introduce you to a person who may be forbidden to marry.

We Wish You Lot’s of Hatzlacha and Siyata D’Shemaya in finding a mate and/or peace in your life. We hope that this questionnaire will help in some way. All the best.

Ohr Binyamin

Glossary:
Mekach Ta’ut – A Marriage Made in Error – Person was not aware of Defect in Other Party only until after Marriage & Marriage was Nullified. Mamzer – Person Born from a Woman who did not receive a valid Get (Jewish Divorce Document) before getting Married to their father. Hallal – A Child born from Father who is/was a Cohen & a Woman Forbidden to Him (ie, a Woman who was divorced from a previous husband, a woman who was promiscuous and/or had relations with a gentile)

Notes – A Person Who is Jewish is One who was born from a Jewish Mother. A Gentile can become Jewish – through a conversion to Judaism with a Reliable Orthodox Beit Din / Court of Law.. It is best to consult a Reliable Orthodox Rabbi – to determine your exact status according to Halacha / Jewish Law.

1)

2)

3) MyselfThe Person Named Below. My Name, Title, Relation to them & Phone Number

4)

5)

6)

7)

8)

9)

10)

11)

12)

13) MaleFemale

14)

15)

16)

17)

18)

19)

20)

21)

22)

23)

24)

25)

26)

27)

28)

29)

30)

31)

32)

33)

34) HappyCalmContentBitternessAngrySulkingDepressedWorriedParanoidLazyHave to Get Things DoneVindictiveHopefulLoveHave Faith in HashemOther

35) BitternessAngrySulkingDepressedWorriedParanoidLazyHave to Get Things DoneUpsetJealous of OthersVindictiveSadOther

36)

37)

38)

39) ProfessionalBusinessFreelanceTorah Learning / Kollel – Part TimeTorah Learning / Kollel – Full TimeTeaching TorahInvolved in Someway Supporting Torah InstitutionWork from HomeHomemakerIn AcademiaAnything that Makes a LivingIn University or School to Learn TradeDon’t Mind Either WayOther

40) UnemployedIn Between JobsWorking Full TimeWorking Part TimeWorking Odd-JobsIn School / UniversityLearning in KollelRetiredSelf-EmployedWorking for Family BusinessOther

41)

42)

43) Jewish through Birth (Mother is Jewish)Jewish – Converted with Orthodox RabbiConverted with Non-Orthodox RabbiGentileOtherOther

44) Jewish through Birth (Mother is Jewish)Jewish – Converted with Orthodox RabbiConverted with Non-Orthodox RabbiGentileOtherOther

45) Jewish through Birth (Mother is Jewish)Jewish – Converted with Orthodox RabbiConverted with Non-Orthodox RabbiGentileOtherOther

46) Jewish through Birth (Mother is Jewish)Jewish – Converted with Orthodox RabbiConverted with Non-Orthodox RabbiGentileOtherOther

47) SingleDivorced – With GetDivorced Civily – No GetMarried – In Process of DivorceWidowedMarried – In Process of DivorceWas Married with Orthodox Rabbi – Has GetWas Married with Non-Orthodox Rabbi – Divorced CivillyMy Mother Had Me Out of WedlockMy Mother Had Me before Receiveing Get / Jewish Divorce Document from Previous HusbandMekakh Ta’utOther

48) SingleDivorced – With GetDivorced Civily – No GetMarried – In Process of DivorceWidowedMarried – In Process of DivorceWas Married with Orthodox Rabbi – Has GetWas Married with Non-Orthodox Rabbi – Divorced CivillyActively Searching – With ShadhanimActively Searching – Through Online ServicesActively Searching by Regularly Calling Friends, Families & Orthodox RabbisActively Searching by Attending Coed Singles EventsNot Searching – Will Date if Someone Comes AlongHad a Mekakh Ta’utOther

49) To Have a Good Time – No Marriage IntentionsTo Have a Fruitful RelationshipTo Determine if a Person is Suitable for MarriageOther

50) Ashkenaz - BornSephardic - BornYemeniteEthiopianMoroccanIranian / PersianHungarianIraqiBoukharianHungarianRussianEastern EuropeanYeshivishTraditionalChasidishLitvakModern OrthodoxLubavitch / ChabadBreslovFollows Ashkenaz Minhagim / TraditionFollows Sephardic Minhagim / TraditionNon-ObservantCohenLeviYisraelMamzerHallalOther

51) Ashkenaz - BornSephardic - BornYemeniteEthiopianMoroccanIranian / PersianHungarianIraqiBoukharianHungarianRussianEastern EuropeanYeshivishTraditionalChasidishLitvakModern OrthodoxLubavitch / ChabadBreslovFollows Ashkenaz Minhagim / TraditionFollows Sephardic Minhagim / TraditionNon-ObservantCohenLeviYisraelMamzerHallalOther

52) Ashkenaz - BornSephardic - BornYemeniteEthiopianMoroccanIranian / PersianHungarianIraqiBoukharianHungarianRussianEastern EuropeanYeshivishTraditionalChasidishLitvakModern OrthodoxLubavitch / ChabadBreslovFollows Ashkenaz Minhagim / TraditionFollows Sephardic Minhagim / TraditionNon-ObservantCohenLeviYisraelMamzerHallalOther

53) Ashkenaz - BornSephardic - BornYemeniteEthiopianMoroccanIranian / PersianHungarianIraqiBoukharianHungarianRussianEastern EuropeanYeshivishTraditionalChasidishLitvakModern OrthodoxLubavitch / ChabadBreslovFollows Ashkenaz Minhagim / TraditionFollows Sephardic Minhagim / TraditionNon-ObservantCohenLeviYisraelMamzerHallalNo PreferenceOther

54)

55)

56)

57) To Love Hash-mTo Be Respectable Members of CommunityTo Enjoy ChildrenTo Have Values of TorahTo Have My Own Personal ValuesTo Be a Contributing Member of SocietyOther

58) In IsraelIn DiasporaNext to ParentsNot Next to ParentsNot Next to InlawsTo Do Kindness with My FamilyTo Teach them to Do KindnessTo Teach them How to Make a LivlihoodTo Enjoy LifeTo Teach them Values Like – Honesty, Integrity & ResponsibilityOther

59) Elementary Secular Public/Private SchoolElementary – YeshivaElementary – Jewish After School/Sunday ProgramHigh School Secular Public/Private SchoolHigh School – YeshivaHigh School – Jewish After School/Sunday ProgramCollege - Secular Public/Private SchoolCollege - Yeshiva / SeminaryCollege – Part Time Jewish School ProgramBachelor of ArtsBachelor of ScienceMasters DegreeMBAPh.D.Home SchooledOther

60) Elementary Secular Public/Private SchoolElementary – YeshivaElementary – Jewish After School/Sunday ProgramHigh School Secular Public/Private SchoolHigh School – YeshivaHigh School – Jewish After School/Sunday ProgramCollege - Secular Public/Private SchoolCollege - Yeshiva / SeminaryCollege – Part Time Jewish School ProgramBachelor of ArtsBachelor of ScienceMasters DegreeMBAPh.D.Home SchooledNo PreferenceOther

61) Elementary Secular Public/Private SchoolElementary – YeshivaElementary – Jewish After School/Sunday ProgramHigh School Secular Public/Private SchoolHigh School – YeshivaHigh School – Jewish After School/Sunday ProgramCollege - Secular Public/Private SchoolCollege - Yeshiva / SeminaryCollege – Part Time Jewish School ProgramBachelor of ArtsBachelor of ScienceMasters DegreeMBAPh.D.Home SchooledNo PreferenceOther

62)

63) Very Handsome / BeautifulHandsome / AttractiveAverage LooksTallAverageShortHeavy SetAverageThinDark SkinnedLight SkinnedBeardClean ShavenCasual ClothesConservatively Elegant ClothesLatest Fashion ClothesNeatCleanModest / Tzanuah Clothing – According to HalakhaNice Teethcommands RespectDemands RespectHonorableRespectfulOther

64) Very Handsome / BeautifulHandsome / AttractiveAverage LooksTallAverageShortHeavy SetAverageThinDark SkinnedLight SkinnedBeardClean ShavenCasual ClothesConservatively Elegant ClothesLatest Fashion ClothesNeatCleanModest / Tzanuah Clothing – According to HalakhaNo PreferenceOther

65) Don’t Learn TorahIf Someone Happens to Say a D’var Torah I LitenWalk Out During Rabbis Dvar TorahLearn Once a Week in a Lecture.Read Torah BooksLearn Torah With Hevruta / Partner Once A MonthLearn Torah With Hevruta / Partner Once A WeekLearn Torah With Hevruta / Partner Once A DayCannot Read HebrewCan Read Hebrew But Not UnderstandCan Understand in Hebrew a Halacha, but Not TalmudCan Understand Halacha, Mishna & Talmud in HebrewCan Teach GemaraDoes Hazara / Reviews RegularlySpend Freetime Learning TorahRead English Books on TorahSay Tehillim / Psalms RegularlyOther

66) Careful to Follow Laws of TzniutFashionable ClothingConservative ClothingCasual ClothingWhen Married Would Rather Cover Hair with Scarf or Wig (Women)When Married Would Rather Cover Hair with Wig (Women)When Married Would Rather Cover Hair with Scarf (Women)When Married Would Rather Not Cover Hair unless Husband DemandsWhen Married Open to Covering Hair (Women)When Married will NOT Cover Hair (Women)Wears a Kippah Most of the Time. (Men)Wears a Kippah only in Home and Synagogue. (Men)Other

67) FireWaterAirEarthExtrovertIntrovertSensingIntuitiveThinkingFeelingJudgementalPercievingLike Open ChoicesLike Things DecidedCreativeMethodicalSmokerNon-SmokerFidel to One MateResponsibleSpontaneousOrganizedPunctualOpen-MindedDemocratRepublicanFidel to One MatePromiscuousLiberal ValuesConservative ValuesTraditional ValuesTorah ValuesValues CommunityLikes to Go OutLikes to Stay HomeLikes to Learn TorahLikes to ReadLikes to Surf WebLikes to Use Social MediaOptimistPessimistBelieve in G-dAtheistAgnosticHave Emuna in Hash-m/G-dBelieve Everything Happens for the GoodTruthfulNot Always TruthfulMoney is Very Important to MeMoney is Necessary – But not so ImportantQuietTalkativeExpressiveReservedShyOutgoingMercifulMercilessKindSelfishGiverTakerLove PeopleHaterLove Jewish PeopleAnimal LoverVegetarianVeganFollowerLeaderLogicalIntelligentThoughtfulAppreciativeDedicated to TorahSports LoverLikes to ShopGambles OccasionallyEloquent CommunicatorClear CommunicatorEmotional CommunicatorRelevant CommunicatorHumorous CommunicatorSeriousJokingSmileyConflictiveResolvingIt’s My Way or HighwayI am Always RightI am Concerned about what People Think of MeSelf ConfidentFashion FollowerDon’t Care What People Think – As Long as It is Right in TorahAttentive to OthersAttentive to Feelings of OthersWarmColdHot-TemperAverage TemperVery CalmLove Hash-mLove TorahLove Chesed / Doing KindnessMany FriendsFew FriendsRespectableHonorableMusical – Plays InstrumentListens to RockListens to Classical MusicListens to EasyListens to ClassicalListens to Jewish MusicArtisticAnimal LoverWealthyWell-to-DoAversion to ReligionAversion to JudaismBitter about Life ExperiencesBitter about Life ExperiencesOther

68) FireWaterAirEarthExtrovertIntrovertSensingIntuitiveThinkingFeelingJudgementalPercievingLike Open ChoicesLike Things DecidedCreativeMethodicalSmokerNon-SmokerFidel to One MateResponsibleSpontaneousOrganizedPunctualOpen-MindedDemocratRepublicanFidel to One MatePromiscuousLiberal ValuesConservative ValuesTraditional ValuesTorah ValuesValues CommunityLikes to Go OutLikes to Stay HomeLikes to Learn TorahLikes to ReadLikes to Surf WebLikes to Use Social MediaOptimistPessimistBelieve in G-dAtheistAgnosticHave Emuna in Hash-m/G-dBelieve Everything Happens for the GoodTruthfulNot Always TruthfulMoney is Very Important to MeMoney is Necessary – But not so ImportantQuietTalkativeExpressiveReservedShyOutgoingMercifulMercilessKindSelfishGiverTakerLove PeopleHaterLove Jewish PeopleAnimal LoverVegetarianVeganFollowerLeaderLogicalIntelligentThoughtfulAppreciativeDedicated to TorahSports LoverLikes to ShopGambles OccasionallyEloquent CommunicatorClear CommunicatorEmotional CommunicatorRelevant CommunicatorHumorous CommunicatorSeriousJokingSmileyConflictiveResolvingIt’s My Way or HighwayI am Always RightI am Concerned about what People Think of MeSelf ConfidentFashion FollowerDon’t Care What People Think – As Long as It is Right in TorahAttentive to OthersAttentive to Feelings of OthersWarmColdHot-TemperAverage TemperVery CalmLove Hash-mLove TorahLove Chesed / Doing KindnessMany FriendsFew FriendsRespectableHonorableMusical – Plays InstrumentListens to RockListens to Classical MusicListens to EasyListens to ClassicalListens to Jewish MusicArtisticAnimal LoverWealthyWell-to-DoAversion to ReligionAversion to JudaismBitter about Life ExperiencesBitter about Life ExperiencesOther

69) 1. Able2. Accepting3. Accessible4. Accomplished5. Accurate6. Adaptable7. Adept8. Adroit9. Affable10. Agile11. Agreeable12. Altruistic13. Ambitious14. Amicable15. Appreciative16. Articulate17. Assertive18. Astute19. Attentive20. Aware21. Beloved22. Benefactor23. Benevolent24. Blissful25. Brave26. Bright27. Brilliant28. Buoyant29. Calm30. Candid31. Capable32. Careful33. Caring34. Cautious35. Charitable36. Cheerful37. Clear38. Colorful39. Compassionate40. Composed41. Confident42. Conscientious43. Considerate44. Consistent45. Content46. Cooperative47. Courageous48. Creative49. Daring50. Dauntless51. Decisive52. Deep53. Deliberative54. Dependable55. Devoted56. Devout57. Dexterous58. Dignified59. Diligent60. Direct61. Discreet62. Easygoing63. Earnest64. Educated65. Effective66. Efficient67. Eloquent68. Energetic69. Enthusiastic70. Erudite71. Ethical72. Exact73. Expressive74. Faithful75. Farsighted76. Flexible77. Fluent78. Forgiving79. Frank80. Friendly81. Frugal82. Generous83. Gentle84. Genuine85. Gifted86. Giving87. Good-natured88. Graceful89. Grateful90. Handy91. Happy92. Hardworking93. Healthy94. Helpful95. Honest96. Honorable97. Hopeful98. Hospitable99. Humane100. Humble101. Idealistic102. Imaginative103. Imperturbable104. Indefatigable105. Industrious106. Intellectual107. Intelligent108. Intrepid109. Influences others110. Interesting111. Introspective112. Jolly113. Joyful114. Kind115. Kindhearted116. Knowledgeable117. Leadership personality118. Learned119. Lenient120. Level-headed121. Likeable122. Lively123. Lofty124. Logical125. Loving126. Loyal127. Magnanimous128. Mature129. Merciful130. Methodical131. Meticulous132. Mild133. Modest134. Moral Natural135. Noble136. Novel137. Obedient138. Objective139. Open140. Optimistic141. Orderly142. Organized143. Original144. Outgoing145. Outspoken146. Painstaking147. Patient148. Peace of mind149. Peaceful150. Perspective151. Persevering152. Persuasive153. Poised154. Polished155. Polite156. PopularOther

70) 157. Potential158. Practical159. Precise160. Productive161. Prompt162. Prudent163. Punctual164. Quiet165. Quieting166. Rapport with people167. Rational168. Realistic169. Reasonable170. Refined171. Relaxed172. Reliable173. Resourceful174. Respectful175. Responsible176. Righteous177. Saintly178. Scholarly179. Scrupulous180. Selfless181. Self-control182. Self-esteem183. Self-respect184. Self-sacrificing185. Sense of humor186. Sensible187. Sensitive188. Serene189. Serious190. Sharp191. Sincere192. Skillful193. Smart194. Sociable195. Speedy196. Spirited197. Spiritual198. Stable199. Steadfast200. Steady201. Straightforward202. Studious203. Sweet204. Swift205. Sympathetic206. Systematic207. Tactful208. Talented209. Tasteful210. Thankful211. Thorough212. Thoughtful213. Thrifty214. Tidy215. Tolerant216. Tranquil217. Trustful218. Trustworthy219. Truthful220. Unafraid221. Understanding222. Upright223. Venturesome224. Vigorous225. Virtuous226. Warm227. Wholehearted228. Wise229. Will-power230. ZestfulOther

71) 1. Able2. Accepting3. Accessible4. Accomplished5. Accurate6. Adaptable7. Adept8. Adroit9. Affable10. Agile11. Agreeable12. Altruistic13. Ambitious14. Amicable15. Appreciative16. Articulate17. Assertive18. Astute19. Attentive20. Aware21. Beloved22. Benefactor23. Benevolent24. Blissful25. Brave26. Bright27. Brilliant28. Buoyant29. Calm30. Candid31. Capable32. Careful33. Caring34. Cautious35. Charitable36. Cheerful37. Clear38. Colorful39. Compassionate40. Composed41. Confident42. Conscientious43. Considerate44. Consistent45. Content46. Cooperative47. Courageous48. Creative49. Daring50. Dauntless51. Decisive52. Deep53. Deliberative54. Dependable55. Devoted56. Devout57. Dexterous58. Dignified59. Diligent60. Direct61. Discreet62. Easygoing63. Earnest64. Educated65. Effective66. Efficient67. Eloquent68. Energetic69. Enthusiastic70. Erudite71. Ethical72. Exact73. Expressive74. Faithful75. Farsighted76. Flexible77. Fluent78. Forgiving79. Frank80. Friendly81. Frugal82. Generous83. Gentle84. Genuine85. Gifted86. Giving87. Good-natured88. Graceful89. Grateful90. Handy91. Happy92. Hardworking93. Healthy94. Helpful95. Honest96. Honorable97. Hopeful98. Hospitable99. Humane100. Humble101. Idealistic102. Imaginative103. Imperturbable104. Indefatigable105. Industrious106. Intellectual107. Intelligent108. Intrepid109. Influences others110. Interesting111. Introspective112. Jolly113. Joyful114. Kind115. Kindhearted116. Knowledgeable117. Leadership personality118. Learned119. Lenient120. Level-headed121. Likeable122. Lively123. Lofty124. Logical125. Loving126. Loyal127. Magnanimous128. Mature129. Merciful130. Methodical131. Meticulous132. Mild133. Modest134. Moral Natural135. Noble136. Novel137. Obedient138. Objective139. Open140. Optimistic141. Orderly142. Organized143. Original144. Outgoing145. Outspoken146. Painstaking147. Patient148. Peace of mind149. Peaceful150. Perspective151. Persevering152. Persuasive153. Poised154. Polished155. Polite156. PopularOther

72) 157. Potential158. Practical159. Precise160. Productive161. Prompt162. Prudent163. Punctual164. Quiet165. Quieting166. Rapport with people167. Rational168. Realistic169. Reasonable170. Refined171. Relaxed172. Reliable173. Resourceful174. Respectful175. Responsible176. Righteous177. Saintly178. Scholarly179. Scrupulous180. Selfless181. Self-control182. Self-esteem183. Self-respect184. Self-sacrificing185. Sense of humor186. Sensible187. Sensitive188. Serene189. Serious190. Sharp191. Sincere192. Skillful193. Smart194. Sociable195. Speedy196. Spirited197. Spiritual198. Stable199. Steadfast200. Steady201. Straightforward202. Studious203. Sweet204. Swift205. Sympathetic206. Systematic207. Tactful208. Talented209. Tasteful210. Thankful211. Thorough212. Thoughtful213. Thrifty214. Tidy215. Tolerant216. Tranquil217. Trustful218. Trustworthy219. Truthful220. Unafraid221. Understanding222. Upright223. Venturesome224. Vigorous225. Virtuous226. Warm227. Wholehearted228. Wise229. Will-power230. ZestfulOther

73) AchieverAgentAppraiserCounselorCreativeDeveloperInspirationalInvestigatorObjective ThinkerPerfectionistPersuaderPractitionerPromoterResult-orientedSpecialistOther

74) AchieverAgentAppraiserCounselorCreativeDeveloperInspirationalInvestigatorObjective ThinkerPerfectionistPersuaderPractitionerPromoterResult-orientedSpecialistOther

75) R: Doers (Realistic)I: Thinkers (Investigative)A: Creators (Artistic)S: Helpers (Social)E:Persuaders(Enterprising)C:Organizers(Conventional)Other

76) R: Doers (Realistic)I: Thinkers (Investigative)A: Creators (Artistic)S: Helpers (Social)E:Persuaders(Enterprising)C:Organizers(Conventional)Don’t Mind Either WayOther

77) Reacts Calmly in All SituationsOverReactsGets Angry or Upset About a Cashier Giving Wrong ChangeSpeeds When in RushWill Burn a Red Light When in RushYells Out Window When Car Makes MistakeBeeps Readily After 2 Seconds of Wait TimeUses ExpletivesUses Expletives When UpsetWhen Someone Does Something Uncooth with Make Sure to Make a CommentFocused on Talking About PeopleSpeaks about big IdeasSpeaks about the Details of Every DaySpeaks About Ideas & BuildingCritical of OthersMind My Own BusinessLet My Emotions Control My ActionsLet My Emotions Control My MoodLike to Boast About MyselfLike to Drop NamesOther

78) GenerosityPromptnessPettinessBitternessStuck on Past ExperiencesAloofnessCarelessSelf-CenteredMoney-HungryExtremely Concerned About MoneyUncaringOther

79) Shomer Negiya – Never Touches Members of Opposite GenderCelibate – No Relations Before MarriageNot Careful About Premarital RelationsVirginNon-VirginDated JewsDated GentilesIntimate with GentileIntimate with a JewPromiscuousSees Pornography RegularlyAbused OthersWas Abused by OthersWas Violated by a Non-JewOther

80) Good Physical HealthDiabetesWears GlassesCannot SeeDeafMuteAngerMissing LimbHandicappedIllnessBarren – Unable to BearHeart ConditionEpilepsyWork InterferenceNegative Treatment IndicatorsBitterOther

81) Good Physical HealthDiabetesWears GlassesCannot SeeDeafMuteAngerMissing LimbHandicappedIllnessBarren – Unable to BearSocial DiscomfortFamily ProblemsWork InterferenceNegative Treatment IndicatorsBitterOther

82) AnxietyFearsObsessivenessDepressionHealth ConcernsBizarre MentationAngerCynicismAntisocial PracticesType A BehaviorLow Self EsteemSocial DiscomfortFamily ProblemsWork InterferenceNegative Treatment IndicatorsHypochondriasisDepressionHysteriaPsychopathic DeviateMasculinity/FemininityParanoiaPsychastheniaSchizophreniaHypomaniaSocial IntroversionSeeing / Saw PsychologistSeeing / Saw PsychologistSeeing / Social WorkerNo Psychological IssuesMinor Psychological Issues – I See a PsychiatristMajor Psychological Issues – I See a Psychiatrist and Taking MedicationWas Sent to Hospital or Mental Ward for Mental IssuesBitterSarcasticAbusiveWas Abused as ChildAddiction to DrugsAddiction to AlcoholADHDADDVindictiveTempermental / MoodySuspiciousQuick to AngerSlow to AngerSlow to CalmQuick to CalmOther

83) AnxietyFearsObsessivenessDepressionHealth ConcernsBizarre MentationAngerCynicismAntisocial PracticesType A BehaviorLow Self EsteemSocial DiscomfortFamily ProblemsWork InterferenceNegative Treatment IndicatorsHypochondriasisDepressionHysteriaPsychopathic DeviateMasculinity/FemininityParanoiaPsychastheniaSchizophreniaHypomaniaSocial IntroversionSeeing / Saw PsychologistSeeing / Saw PsychologistSeeing / Social WorkerNo Psychological IssuesMinor Psychological Issues – I See a PsychiatristMajor Psychological Issues – I See a Psychiatrist and Taking MedicationWas Sent to Hospital or Mental Ward for Mental IssuesBitterSarcasticAbusiveWas Abused as ChildAddiction to DrugsAddiction to AlcoholADHDADDVindictiveTempermental / MoodySuspiciousQuick to AngerSlow to AngerSlow to CalmQuick to CalmOther

84) Hold and Talk on Cell Phone While DrivingText while DrivingSurf While DrivingStoleKilled a PersonWas in PrisonGot Traffic TicketGot Speeding TicketWait for Walk SignDon’t Wait for Walk SignWait for Green LightDon’t Wait for Green LightDrive in Bus LaneSpeedWas Convicted of a Minor CrimeWas Convicted of a Major CrimeWas Put in Jail – For White Collar CrimeWas Put in Jail – For CrimeWas Put in Jail – OtherDrive CarefullyDrive or Drove While IntoxicatedWas Put in Prison for ViolenceWas Violent with Wife or HusbandRaises Voice Frequently to Get One’s WayHangs Up on Cold CallersYells at CashiersYells at Drivers that Cut you OffImpatient with WaiterTips GenerouslyDoes not TipTips AverageWould Rather Spend for Myself than OthersWould Rather Spend for Others than for MyselfOther

85) Hold and Talk on Cell Phone While DrivingText while DrivingSurf While DrivingStoleKilled a PersonWas in PrisonGot Traffic TicketGot Speeding TicketWait for Walk SignDon’t Wait for Walk SignWait for Green LightDon’t Wait for Green LightDrive in Bus LaneSpeedWas Convicted of a Minor CrimeWas Convicted of a Major CrimeWas Put in Jail – For White Collar CrimeWas Put in Jail – For CrimeWas Put in Jail – OtherDrive CarefullyDrive or Drove While IntoxicatedWas Put in Prison for ViolenceWas Violent with Wife or HusbandRaises Voice Frequently to Get One’s WayHangs Up on Cold CallersYells at CashiersYells at Drivers that Cut you OffImpatient with WaiterTips GenerouslyDoes not TipTips AverageWould Rather Spend for Myself than OthersWould Rather Spend for Others than for MyselfOther

86) Have Child(ren)Do Not Have ChildrenWant to Bear Children – 3 or LessWant to Bear Children – 4 or MoreWant as Many Children as I can Support FinanciallyDo Not Want to Bear More ChildrenDo Not Want Mate who has ChildrenLove ChildrenDont Mind Either WayOther

87) Have Child(ren)Do Not Have ChildrenWant to Bear Children – 3 or LessWant to Bear Children – 4 or MoreWant as Many Children as I can Support FinanciallyDo Not Want to Bear More ChildrenDo Not Want Mate who has ChildrenLove ChildrenDont Mind Either WayOther

88) Able to Bear ChildrenNot Able to Bear ChildrenNot SureOther

89) Able to Bear ChildrenNot Able to Bear ChildrenNot SureDont Mind Either WayOther

90) Good Physical HealthAverage Physical HealthBelow Average Physical HealthOther

91) Good Physical HealthAverage Physical HealthBelow Average Physical HealthOther

92) Total Observance of Shulchan AruchLearns Torah RegularlyAttends Torah LecturesListens to Torah LecturesShomer Shabbat / Shabbat ObserverKeeps KosherPrays RegularlyAttends Synagogue Services – DailyAttends Synagogue Services – WeeklyAttends Synagogue Services – YearlyGoes to MikveMale - Covers Hair with Kippa OutsideFemale – Does Not Cover HairFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair with Shaitel / Wig & ScarfFemale – Covers Hair Only with ScarfTV in HomeGoes to MoviesReads Romance NovelsUses SmartphoneWatches Videos OnlineSeder, Someone in HouseholdChanukah Candles Lit in HouseholdYom Kippur, Respondent Fasts All DayBeing Jewish Very Important in Respondent’s LifeGave to Jewish Charities, Household GaveRespondent’s Closest Friends Are Mostly JewishWent to a Jewish Museum or Jewish Cultural Event, Respondent in Past YearShabbat Meal, Respondent ParticipatesVery Important to Be Part of a Jewish CommunitySynagogue Member, Anyone in HouseholdIsrael, Respondent Feels Very AttachedRespondent Talks Regularly About Jewish-Related Topics With Jewish FriendsRespondent Studies Informally, Alone, With Friend, or With TeacherJewish Websites, Respondent AccessesRespondent Feels Part of a Jewish CommunitySabbath Candles Lit Friday Night in HouseholdAdult Jewish Educational Programs, Respondent Engaged in Past YearAnyone in Household Went to a Torah Program, Past YearKosher HomeVolunteered for a Jewish Organization - Past YearVery ImportantNot So ImportantNot at All ImportantGrowth In Torah and/or Mitzvot Very ImportantGrowth In Torah and/or Mitzvot ImportantGrowth In Torah and/or Mitzvot Not So ImportantBeing a Good Person is what Really Matters Over Doing Mitzvah’s DetailsBeing a Good Person & Observing Ritual Mitzvot are Both importantTV in HomeInternet (Filtered) at HomeInternet (Unfiltered) at HomeFather Learning in a KollelOther

93) Total Observance of Shulchan AruchLearns Torah RegularlyAttends Torah LecturesListens to Torah LecturesShomer Shabbat / Shabbat ObserverKeeps KosherPrays RegularlyAttends Synagogue Services – DailyAttends Synagogue Services – WeeklyAttends Synagogue Services – YearlyGoes to MikveMale - Covers Hair with Kippa OutsideFemale – Does Not Cover HairFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair with Shaitel / Wig & ScarfFemale – Covers Hair Only with ScarfTV in HomeGoes to MoviesReads Romance NovelsUses SmartphoneWatches Videos OnlineSeder, Someone in HouseholdChanukah Candles Lit in HouseholdYom Kippur, Respondent Fasts All DayBeing Jewish Very Important in Respondent’s LifeGave to Jewish Charities, Household GaveRespondent’s Closest Friends Are Mostly JewishWent to a Jewish Museum or Jewish Cultural Event, Respondent in Past YearShabbat Meal, Respondent ParticipatesVery Important to Be Part of a Jewish CommunitySynagogue Member, Anyone in HouseholdIsrael, Respondent Feels Very AttachedRespondent Talks Regularly About Jewish-Related Topics With Jewish FriendsRespondent Studies Informally, Alone, With Friend, or With TeacherJewish Websites, Respondent AccessesRespondent Feels Part of a Jewish CommunitySabbath Candles Lit Friday Night in HouseholdAdult Jewish Educational Programs, Respondent Engaged in Past YearAnyone in Household Went to a Torah Program, Past YearKosher HomeVolunteered for a Jewish Organization - Past YearVery ImportantNot So ImportantNot at All ImportantGrowth In Torah and/or Mitzvot Very ImportantGrowth In Torah and/or Mitzvot ImportantGrowth In Torah and/or Mitzvot Not So ImportantBeing a Good Person is what Really Matters Over Doing Mitzvah’s DetailsBeing a Good Person & Observing Ritual Mitzvot are Both importantOther

94) Total Observance of Shulchan AruchLearns Torah RegularlyAttends Torah LecturesListens to Torah LecturesShomer Shabbat / Shabbat ObserverKeeps KosherPrays RegularlyAttends Synagogue Services – DailyAttends Synagogue Services – WeeklyAttends Synagogue Services – YearlyGoes to MikveMale - Covers Hair with Kippa OutsideFemale – Does Not Cover HairFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair with Shaitel / Wig & ScarfFemale – Covers Hair Only with ScarfTV in HomeGoes to MoviesReads Romance NovelsUses SmartphoneWatches Videos OnlineSeder, Someone in HouseholdChanukah Candles Lit in HouseholdYom Kippur, Respondent Fasts All DayBeing Jewish Very Important in Respondent’s LifeGave to Jewish Charities, Household GaveRespondent’s Closest Friends Are Mostly JewishWent to a Jewish Museum or Jewish Cultural Event, Respondent in Past YearShabbat Meal, Respondent ParticipatesVery Important to Be Part of a Jewish CommunitySynagogue Member, Anyone in HouseholdIsrael, Respondent Feels Very AttachedRespondent Talks Regularly About Jewish-Related Topics With Jewish FriendsRespondent Studies Informally, Alone, With Friend, or With TeacherJewish Websites, Respondent AccessesRespondent Feels Part of a Jewish CommunitySabbath Candles Lit Friday Night in HouseholdAdult Jewish Educational Programs, Respondent Engaged in Past YearAnyone in Household Went to a Torah Program, Past YearKosher HomeVolunteered for a Jewish Organization - Past YearVery ImportantNot So ImportantNot at All ImportantGrowth In Torah and/or Mitzvot Very ImportantGrowth In Torah and/or Mitzvot ImportantGrowth In Torah and/or Mitzvot Not So ImportantBeing a Good Person is what Really Matters Over Doing Mitzvah’s DetailsBeing a Good Person & Observing Ritual Mitzvot are Both importantOther

95) Total Observance of Shulchan AruchLearns Torah RegularlyAttends Torah LecturesListens to Torah LecturesShomer Shabbat / Shabbat ObserverKeeps KosherPrays RegularlyAttends Synagogue Services – DailyAttends Synagogue Services – WeeklyAttends Synagogue Services – YearlyGoes to MikveMale - Covers Hair with Kippa OutsideFemale – Does Not Cover HairFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair Only with Shaitel / WigFemale – Covers Hair with Shaitel / Wig & ScarfFemale – Covers Hair Only with ScarfTV in HomeGoes to MoviesReads Romance NovelsUses SmartphoneWatches Videos OnlineSeder, Someone in HouseholdChanukah Candles Lit in HouseholdYom Kippur, Respondent Fasts All DayBeing Jewish Very Important in Respondent’s LifeGave to Jewish Charities, Household GaveRespondent’s Closest Friends Are Mostly JewishWent to a Jewish Museum or Jewish Cultural Event, Respondent in Past YearShabbat Meal, Respondent ParticipatesVery Important to Be Part of a Jewish CommunitySynagogue Member, Anyone in HouseholdIsrael, Respondent Feels Very AttachedRespondent Talks Regularly About Jewish-Related Topics With Jewish FriendsRespondent Studies Informally, Alone, With Friend, or With TeacherJewish Websites, Respondent AccessesRespondent Feels Part of a Jewish CommunitySabbath Candles Lit Friday Night in HouseholdAdult Jewish Educational Programs, Respondent Engaged in Past YearAnyone in Household Went to a Torah Program, Past YearKosher HomeVolunteered for a Jewish Organization - Past YearVery ImportantNot So ImportantNot at All ImportantGrowth In Torah and/or Mitzvot Very ImportantGrowth In Torah and/or Mitzvot ImportantGrowth In Torah and/or Mitzvot Not So ImportantBeing a Good Person is what Really Matters Over Doing Mitzvah’s DetailsBeing a Good Person & Observing Ritual Mitzvot are Both importantOther

96) It is a Necessary Part of Life So I Deal with ItIt is Very Important to HaveA Person Should be Careful About ExpensesMaking Money is Very ImportantI Watch Daily My Stocks to See My WorthA Person Should Watch Their Expenses Very Carefully.Money Should be Spent Only for Bare NeccesitiesA Person Should Have an Annual BudgetI’m Not So Careful About Spending Because I Believe in G-dA Person Should Work Hard For His MoneyWomen are Overly Concerned About MoneyA Woman Should Marry a Person Who is WealthyA Man Should Marry a Wealthy WomanMost People who are Poor Don’t Deserve Charity – They Should Get a JobOne Should Give Money to Everyone Who Sticks Out his Hand or AsksA Person Should Have a Budget and Stick to ItOne Should Give Money to Maximize His Tax ExemptionOne Should Not Give Away Money UnneccesarilyA Rich Person Has More of an Obligation to Give CharityI’d Rather Give Money than Get MoneyI’d Rather Get Money than Give MoneyGenerousStingyGood HeartClosed WalletOther

97) It is a Necessary Part of Life So I Deal with ItIt is Very Important to HaveA Person Should be Careful About ExpensesMaking Money is Very ImportantI Watch Daily My Stocks to See My WorthA Person Should Watch Their Expenses Very Carefully.Money Should be Spent Only for Bare NeccesitiesA Person Should Have an Annual BudgetI’m Not So Careful About Spending Because I Believe in G-dA Person Should Work Hard For His MoneyWomen are Overly Concerned About MoneyA Woman Should Marry a Person Who is WealthyA Man Should Marry a Wealthy WomanMost People who are Poor Don’t Deserve Charity – They Should Get a JobOne Should Give Money to Everyone Who Sticks Out his Hand or AsksA Person Should Have a Budget and Stick to ItOne Should Give Money to Maximize His Tax ExemptionOne Should Not Give Away Money UnneccesarilyA Rich Person Has More of an Obligation to Give CharityI’d Rather Give Money than Get MoneyI’d Rather Get Money than Give MoneyGenerousStingyGood HeartClosed WalletOther

98) Listens To PartnerAccepts Criticism without Being OffendedPatient to JudgeQuick to JudgeRespects Partner’s Rght to TalkRespects Partner’s SuggestionsRespects Partner’s IdeasLooks Down Upon Views DissimilarHas Contempt for Partners FailingsDemands RespectCommands RespectHarsh startups - begins discussion with partner using criticism, sarcasm, or harsh words.Uses criticism oftenHas contempt for partnerDefensive in ConversationStonewalling (withdrawal) – gives Silent Traeatment when UpsetPositiveNegativeDisagrees without being DisagreeableLet’s Emotions Drive their ConversationsIn ControlLets Torah Drive their EmotionsFlooding – Overwhelming NegativityWants to Be RightWants to Do What’s RightUses Problem Solving TechniquesEmpatheticTry to Calm Things DownEscalates Conflicting ConversationsPeacefulAggresiveBring Back Good MemoriesBring Back Bad MemoriesAprreciativeOther

99) Listens To PartnerAccepts Criticism without Being OffendedPatient to JudgeQuick to JudgeRespects Partner’s Rght to TalkRespects Partner’s SuggestionsRespects Partner’s IdeasLooks Down Upon Views DissimilarHas Contempt for Partners FailingsDemands RespectCommands RespectHarsh startups - begins discussion with partner using criticism, sarcasm, or harsh words.Uses criticism oftenHas contempt for partnerDefensive in ConversationStonewalling (withdrawal) – gives Silent Traeatment when UpsetPositiveNegativeDisagrees without being DisagreeableLet’s Emotions Drive their ConversationsIn ControlLets Torah Drive their EmotionsFlooding – Overwhelming NegativityWants to Be RightWants to Do What’s RightUses Problem Solving TechniquesEmpatheticTry to Calm Things DownEscalates Conflicting ConversationsPeacefulAggresiveBring Back Good MemoriesBring Back Bad MemoriesAprreciativeOther

100)

101)

102)

103) NoYes – a ReferenceYes – a ParentYes – a FriendOther

104) With No OneWith a Potential MateWith Other ShadhanimWith Shadhanim that Do not Charge a FeeWith Rabbi of Potential MateWith My ParentsOther

105) With No OneWith a Potential MateWith Other ShadhanimWith Shadhanim that Do not Charge a FeeWith Rabbi of Potential MateWith My ParentsOther

106)

107)

108)

109)

110)

111) I Do Not Affirm the Truth, Thoroughness or Completeness of Answers & Information I Provided AboveI Hereby Do Affirm the Truth, Completeness & Thoroughness of the Answers and Information I Provided AboveI Affirm that I Answered the Answers that I Felt Like Answering TruthfullyOther

112)

113)