Apply to Become a Member

'.$error_message.'

'; ?> Please submit your information below and we'll be contacting you shortly.
Feel free to refer to our Admission Process and Flow Chart for more information.

To apply to become a member of the Professional Matchmakers' Network, you need to submit your bio and be approved by the Board of Directors.

To apply for Membership:

First Name: Enter your first name.'; ?>
Last Name: Enter your last name.'; ?>
Gender Select your gender.'; ?> > Male   > Female
Status:
Company Name:
(if any)
How long have you been established as a Matchmaker?
Clients' Portfolio
(Approximate number) Enter your clients\' portfolio.'; ?>
Membership Cost Enter your Membership Cost & Type.'; ?>  US$ 
Do you want your membership cost to be visible? Select one of the 2 options.'; ?> > Yes   > No
Membership cost includes
(List all services included) Enter what is included in your membership.'; ?>
Address Enter your address.'; ?>
City Enter your city.'; ?>
State
Zip Code Enter your Zip Code.'; ?>
Country Select your country.'; ?>
Providing services to the following areas
(i.e. Tri-State area, county, different cities...) Enter the ares you provide services for.'; ?>
Work Phone - -
Cell Phone - -
Home Phone - -
Birthday (Month - Day - Year) - -
Do you want your age to be visible? > Yes   > No
E-mail: Enter your e-mail address.'; ?>
Re-type E-mail: Enter the same e-mail address as above.'; ?>
Alternative E-mail:
Password:
(to access the network once approved) Enter your password.'; ?>
Re-type Password: Enter the same password as above.'; ?>
Clients' age range : to
Your paid clients are Enter your specialisation.'; ?> > Men only   > Women only   > Both
If you have freebies for matches they are > Men only   > Women only   > Both
If you specialize in a specific community
In addition to English, what language do you speak?
(if any)
Upload your photo
Max size: 200 K
Formats: JPG, JPEG, GIF, PNG.
'.$error_message.''; ?>

More about your company/service - 30 words maximum
(to emphasize your niche market - please don't use capital letters, words like "best" etc)
Enter your services/company information.'; ?>

More about your personal style (when serving your clients) - 30 words maximum
Enter your personal style.'; ?>

Your Bio - 150 words maximum
Enter your bio.'; ?>