Your email address:
Other email addresses you have, should we be unable to contact you during the next 12 months with the email address above:
Your muslim name:
Your legal name:
[optional] Your Paltalk I.D.
Your gender:	Female Male
Your age:
City and State/Province etc. you live in:
Country:	Select One United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia (Hrvatska) Cuba Cyprus Czech Republic Czechoslovakia (former) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain (UK) Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (North) Korea (South) Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia New Zealand (Aotearoa) Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda S. Georgia and S. Sandwich Isls. Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu US Minor Outlying Islands USSR (former) Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
Do you regularly observe salah?	- Select One - Yes Most of the Time Sometimes No
How long have you been muslim?
Please select all that apply to you (may select more than one):	Hold down the CTRL key to select more than one! Muslim Sunni Shia Sufi Respect W. Deen Mohammed as a Scholar Nation of Islam Adhere to salafi dawah, insha'Allah Shafii Muthab Maliki Muthab Hanafi Muthab Hanabali Muthab Tableeghi Not a Muslim 5%er Ansari
Are you able and willing to MOVE?	Yes No
Please list any details as to where you are willing to move to, or NOT willing to move to:
What attributes are important to you, that your future spouse MUST be, in order for you to consider for marriage?
What attributes are important to you, that your future spouse must NOT be, in order for you to consider for marriage?
How many times have you been married?
List the ages of all children you have
What is your current work status?	- Select One - Work full time Work part time Not currently employed Too young to work
Why do you want to get married?
Do you allow pictures of animals or people on the walls of your dwellings?	Yes No
Do you smoke or drink?
Do you have a sexually transmitted disease? If so, what:
Are you willing to marry someone with a sexually transmitted disease?	Yes Possibly No
OPTIONAL! Select any of the following items that describe you (select more than one) If you are filling this out for someone else, just do your best but don't worry too much.... this is just a starting point of introductory information:	Hold down the CTRL key to select more than one! ------PHYSICAL ATTRIBUTES------- Fat Skinny Average Weight Short Average Height Tall ----------PERSONALITY----------- Easy going Gentle Sentimental Fact oriented Emotional based Not very neat and organized Very organized Very clean Sometimes a worrier Do not do well with stressful situations -----------ISLAM/OTHER--------- Know how to do salah all by myself Still learning how to do salah all by myself Have surahs memorized in Arabic Speak arabic fluently Know some arabic Not interested in learning arabic Speak English fluently Learning to speak english Fluently speak Urdu Speak some Urdu Revert to Islam Born and stayed muslim other members of my family are muslim --------MISC-------------- Believe it is okay for a wife to be struck Have been in prison Have pets Have family photos on wall ------- RACE, ETC. (OPTIONAL!) -------- African African-American American Arab Asian Brittish Black Chinese Hispanic Pakistani White Race: Other -----------SKILLS/HOBBIES----------- Can Cook Very Well Can Cook a Little Bit Can't cook Don't like to cook Only like to cook on occasion Can sew very well Can sew a little Watch a lot of t.v. Seldom watch t.v. Average t.v. viewer Like to paint or draw
OPTIONAL! Items that I am looking for in a spouse (select as many traits as you see... anything not listed here, please mention in the comments section at the end of this page):	Hold down the CTRL key to select more than one ----ACCEPTABLE Physical Attributes---- Fat Skinny Average Weight Short Average Height Tall --------DESIRED Islamic Traits--------- Must make salah regularly Must wear hijab if a woman Must have a beard if a man Must wear niqab Prefer she wears niqab OK if the person is a new revert to Islam Born and stayed muslim -----------LANGUAGE----------- Must speak arabic fluently Must desire to learn arabic Must speak English fluently Must speak enough english to hold a conversation Fluently speaks Urdu Speaks some Urdu -------DESIRED FAMILY STATUS-------- Parent(s) are muslim has no children has no adult children children are okay, depending on the age no more than 2 children children are okay must be able to have children as far as s/he knows is okay if cannot have children members of her/his family are muslim okay if divorced must be widowed or never married -----ACCEPTABLE RACES OF SPOUSE----- African African-American American Arab Asian Brittish Black Chinese Hispanic Pakistani White Race: Other Race of my spouse is not important Race of my spouse is somewhat important to me Race of my spouse is very important to me -------DESIRED/ACCEPTABLE Skills of new spouse----- Can Cook Very Well Can Cook a Little Bit Can't or don't cook Ok if just learning how to cook as long as willing to Cook on occasion Can sew very well Can sew a little Watch a lot of t.v. Seldom watch t.v. Average t.v. viewer -------------MISC------------- Must not hang pictures of animals/people on wall Must not have been in prison Must not have pet(s)

ONLY FEMALES should fill out this section        (male section is below!)

Your wali's name/relationship: [Females Only]
Your wali's phone number(s) and any additional contact info:[Females Only]
Your wali's email address [optional]:[Females Only]
Do you wear hijab?[Females Only]	- Select One - Yes Sometimes No
Do you wear niqab?[Females Only]	- Select One - Yes Sometimes No
When married, what is your attitude/desire towards you working?[Females Only]	I intend to work full-time I intend to work part-time It depends May work, but not outside the home Willing to live within my husbands means, rich or poor I do not want to have to work
What may his face look like?[Females Only]	Hold down the CTRL key to select more than one! Regularly clean-shaven Usually Clean-shaven Goatie Trimmed Moustache Well-groomed beard that is trimmed short Beard not shaved, moustache trimmed No preference
Are you willing to be a co-wife to a man who is already married?[Females Only]	Yes No
If you are to be his first wife, what are your feelings towards him having an additional wife(s) down the road?[Females Only]	(Please select as many as apply) Hold down the CTRL key to select more than one! Supportive and willing Supportive with certain conditions met first Supportive but only if all wife(s) are muslim Possibly I am not sure I would want to divorce him I am totally against polygyny

ONLY MALES should fill out this section

Are you currently married? [Males Only]	Yes No
Name of Imam and/or Masjid that you attend.  Provide email address, website, and/or PalTalk I.D. of Imam if available. [Males Only]
Do you shake women's hands? [Males Only]	Yes Sometimes No
Describe your face: [Males Only]	Regularly clean-shaven Usually Clean-shaven Goatie Trimmed Moustache Well-groomed beard that is trimmed short Don't shave off any part of beard, and trim moustache
Describe your hair: [Males Only]	Hair is short to average length Hair is shoulder length Hair is past shoulders Shave my head
Do your pant legs hang past your ankle? [Males Only]	Yes Usually Yes Usually No No
What is your attitude towards her wearing hijab? [Males Only]	Hold down the CTRL key to select more than one She must wear full hijab I prefer a woman who wears full hijab She must wear niqab I prefer a woman who wears niqab regularly I prefer a woman who wears niqab sometimes It depends on other aspects of her personality It's up to her
Can you financially support a new wife? [Males Only]	No It depends on if she thinks my income is adequate Yes
What is your current income range? [Males Only]	Receive aid from government $0 to $9,000 annually $10,000 to $16,000 annually $17,000 to $22,000 annually $23,000 to $29,000 annually $30,000 to $35,000 annually $36,000 to $45,000 annually $45,000 to $55,000 annually Over $55,000 annually I prefer not to disclose at this time
What is your current housing status? [Males Only]	Own a house Rent Live with parents or other relative(s) Other

OTHER (FOR MALES O&R FEMALES)

Please tell us a little about yourself and your quest for a spouse. If you are filling this out for someone else (such as for someone who has no access to the internet), please note that here as well.  The more information we have available, the quicker, insha'Allah, this process may take.

Method of Payment: PayPal.com Will Mail Check or Money Order within 2 weeks Only consider me as a candidate for others This application is only an update to my previous submission

If paying by check or money order, make it out to Muttaqun Foundation. Must be in U.S. dollars. Mail payment promptly to:

Muttaqun Foundation

P.O. Box 602

Winter Park, FL 32790

USA

PayPal.com payments may be sent to store@muttaqun.com

Your application will not be processed until your $20 donation is received. We also appreciate additional donations. Your donation is considered a gift and is non-refundable.

Thank you and May Allah grant you success in your marriage quest!