Name *

First Name

Last Name

Phone *

(###)

###

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Are you currently a Datefit member? *

*Both individuals within the submitted application form must be new Datefit users. Both users must have connected through the Datefit app.

Yes

No

Are you a Datefit Premium member? *

*Applicant must be a Datefit premium user in order to be approved.

Yes

No

What is Your Date's Phone Number? *

(###)

###

####

Did you and your date match on Datefit? *

Yes

No