Match Making Questionaire

This could be the start to your happily ever after. You have made a step that many have not made; an action towards the change you want. You understand that if you always do what you've always done, that you can expect to get what you've always gotten. Whether its the Extremely Classy, Upscale, "A Dozen Dates.. A Dozen Roses" event, 1 on 1 relationship counseling with one of our qualified and trusted counselors or whether its pinpoint match making dating sessions just for you.. Your best is yet to come!

There is a separate $20 evaluation fee for the "A Dozen Dates.. A Dozen Roses" live event which is due at the time of form submission. This fee is being waived for the month of September 2015.

Just numbers with no dashes

About Your Match

After submitting form, please send a recent high quality headshot and a separate body shot to and your full name to Timothy@JonesMotivation.com

Because this form is so long.. After you press submit and it accepts, you may have to scroll up to read the welcome message.

Thank you for your time and kind regards. Rest assured it was time well spent. There is love in the air! - Timothy "Motivation" Jones 704-856-9649