Birmingham Islamic Society

Matrimonial Prospect Form

Please complete all the information in this form for it to be processed properly. If you need help or have questions about this form, please contact us at bismatrimonial@bisweb.org.

About Yourself

Name

Street Address

City	State	ZIP

Home Phone	Cell Phone

E-mail Address

Date of Birth

Height

Build (please describe)

Nationality

First language

Other spoken languages

Highest degree obtained

Marital status

Single, never married Divorced Widowed

Do you have children?

Yes No

If yes, how many and how old?

If you were NOT born in America, please answer the following two questions:

Current status

Citizen Green card holder Immigrant Non-immigrant Student

Number of years in the US

Attend Islamic programs

Weekly Monthly Occasionally Rarely Never

How long have you been Muslim?

I evaluate my Islamic knowledge to be

Very good Good Fair Poor

Do you have any family in the US?

Yes No

If yes, what relationship?

With whom do you live now?

Reference in the US:

Name

Street Address

City	State	ZIP

Home Phone	Cell Phone

E-mail Address

 

Describe yourself

Describe your personality and character:

I like to spend my time:

 

What are you looking for in a future spouse?

Are you willing to relocate?

Yes No

What is the age range you are looking for?

Preferences for matrimonial match (check all that apply)

Indian Pakistani Bengali Arab African-American European Caucasian Oriental West Indian Hispanic No preference

Describe your expectations and requirements for your potential spouse:

Describe things that you would not accept in your potential spouse (i.e. smoking, etc.):

 

For sisters only

Do you wear complete hijab?

Yes No Sometimes

If no, are you willing to wear it when married?

Yes No Undecided

Do you wear niqab?

Yes No

Wali information (Required):

Name

Street Address

City	State	ZIP

Home Phone	Cell Phone

E-mail Address

 

Agreement

By pressing the submit button below, I hereby certify that the information given in this form is true, correct and complete in every respect. If there are any changes in my information I will contact BIS as soon as possible.