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Becky: At The Well Application Form

Use this form to provide an in-depth insight on your goals, values, beliefs, relationship (past & current - if any), and preference. We encourage 100% honesty and transparency. All of the information provided is kept private and confidential. Thank you!

Click the button below to start.

Start

Question 1 of 13

Do you have a profile on Becky?

A

Yes

B

No

Question 2 of 13

Have you ever been married?

A

Yes

B

No

Question 3 of 13

If you answered yes, tell us about your previous marriage. The more information the better.

Question 4 of 13

Tell us more about your preference: Age Range, Height, Career Expectations, Physical Structure, Location, etc. 

Question 5 of 13

Have you gone through any form of mentorship and preparation to prepare you for marriage?

A

Yes

B

No

Question 6 of 13

Tell us more about your preparation journey for marriage?

Question 7 of 13

Briefly describe what you do for living?

Question 8 of 13

Becky At The Well is currently discounted at $1979. Are you willing and able to invest this amount towards finding purposeful love?

A

Yes

B

No

Question 9 of 13

Enter Your Name: First and Last Name as seen on your profile on Becky. Otherwise, enter n/a.

Question 10 of 13

Do you have any kids?

A

Yes

B

No

Question 11 of 13

Do you want any kids?

A

Yes

B

No

Question 12 of 13

How did you hear about Becky: At The Well?

A

YouTube

B

Instagram

C

Facebook

D

TikTok

E

Word of Mouth

Question 13 of 13

Blank Slate (Use this space to capture any other relevant information about yourself and/or your preference.)

Confirm and Submit