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Cart
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Black Love Pizza Party
Shop
T-Shirts
Hoodies
Black Love Is Dope
Crew Neck Sweat Shirt
Camp Black Love
Books, Posters & Prints
Accessories
About
Podcast
Coaching Session
Blog
Contact
Email
Email isn't required however if we have any farther questions this would be a great way to contact you
Age
*
Choose one
21-24
25-35
36-45
46-55
56-65
65 & over
Relationship Status
*
Choose One
Single
Married
Divorced
In a relationship
Race
*
African American
White
Hispanic
Native American
Caribbean
Middle Eastern
Other
Other
Another Nationality
Religion
*
Choose One
Christian
Muslim
Jewish/Hebrew
5 Percent Nation
Buddhist
Hindu
Yoruba
Atheist
Other
Other (Religion)
Region
*
What region of the US where raised?
Northeast
South
Midwest
West Coast
Other Region
Who Raised You?
*
Answer One
Mom & Dad (One Household)
Mom & Dad (Shared Custody)
Mother Only
Father Only
Extended Family
Adopted
Foster
Other
Who raised other than the boxes above
Relationship Questions
*
Money is very important in my relationships.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My partner has to have a form spiritual development.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Sex is very important in my relationship.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My partner has to be employed.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My partner has to have some form of college education
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My partner salary should be equal or above mine.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My partner has to want kids.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Marriage is important to me.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have healthy relationships with men.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have healthy relationships with women.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
List 3 things you want to see the men in your life improve on.
*
List 3 things you want men to know about women.
*
List 3 thing you want men to know about money.
*
List 3 things you want your men to know about women's body.
*
Do you share books, podcast & conferences with men?
*
Why or Why Not?
What do you do when you notice the men in your life are stressed?
*
check your top 3
Pray for him
Send him a Podcast, Ted Talk or Interview
Buy him a book
Buy ticket to conference or workshop
Go on vacation
Talk him through it
Leave him Alone
Recommend The Doctor
Recommend he plays a sport or exercise
Do you pray with the men in your life?
*
Yes
No
Sometimes
Do you workout with the men your life?
*
Yes
No
Sometimes
Do you eat with the men in your life?
*
Yes
No
Sometimes
Questions
Thank you!