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Please provide your contact information:

All the contact information we collect is exclusively personal and confidential and to be used on behalf of JConnect Dallas social networking purposes ONLY.

(Please complete the following and be honest in your responses. Thank you!)

First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Phone:
Cell Phone:
Email:
 
Marital Status:
Single
Separated
Divorced
Widowed
 
Age Range:
40-45
46-50
51-55
56-60
60+

Which of the following events & activities would you like to see offered and participate through JConnect Dallas?

Please indicate which group and specific interest you want to participate (check all that apply)

 

Social Group:




Group Trips




Sports Group:





Cultural Group:




Other - Give us your ideas


Community Service Group:

Local Fund Raising and Charity:
Other - Give us your ideas

Educational Group:





Other - Give us your ideas

 

Please indicate your Interest and Participation with JCONNECT DALLAS:
(pick all that apply) 

Group Leader -  ( GL )
Group Member - ( GM )
Activity Member - ( AM )

Please mark below which one you want to participate in .  Mark GL, GM or AM.  If not interested , then leave blank


Cultural Group

Community Service Group


                                               

Please tell your friends about J Connect Dallas and have them join us in the 40+ Dallas Jewish Singles Community.
Welcome to JConnectDallas for the 40+ Jewish Singles Community
It's You. It's Different. It's Time.
TM
 

 

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