NCSC Date Night
  • Fill out this form to be eligible for invites to future events.
  • Invites are based on your number of eligible matches in the speed dating pool.
  • None of the information you provide will be shared externally.
* Required
What is your first and last name? *
What is your email address? *
Make sure you input your email address correctly!
Please confirm your email address: *
What is your cell phone number? *
What is your gender? *
What is your Date of Birth? *
Please confirm your age: *
What's the youngest age you'd be willing to date? *
What's the oldest age you'd be willing to date? *
In which country do you live? *
If you live in a country that isn't in the list, please let us know!
In which city do you live? (select nearest city) *
If you live near a big city that isn't in the list, please let us know!
In which language(s) are you open to date? (check all that apply) *
Are you open to a long distance relationship? *
Do you give NCSC and DateNight.AI permission to use the data provided for match making purposes? *