girlfriend application  

BROC817 45M
874 posts
6/25/2006 6:34 am

Last Read:
6/25/2006 11:02 am

girlfriend application

This application must be filled out in its entirety in order to be considered for the position that you are applying. Photographs may sway my opinion one way or the other, feel free to attach any that you think may help you gain this position. Any false information will automatically nullify any chance you might have had. Thanks.


1. Full legal name:
2. Age:
3. Height:
4. Weight:
5. Eye color:
6. Measurements:
7. Natural hair color:
8. Current hair color:


9. Home phone:
10. Cell Phone:
11. Email:
12. Myspace:
13. instant messanger:
14. Work:
15. Pager:


16. Are you a virgin?
17. If no, how many past sexual partners have you had?
18. Have you ever had a sex change?
19. Do you smoke?
20. Do you use any illegal substances?
21. Do you have kids?
22. If yes, how many?
23. Do you workout?
24. Do you currently have a source of income?

26. Do you live on your own?
27. If no, whom do you currently reside with?
28. Do You Drive?
29. If so, what kind of car do you drive?
30. Furthest level of education?
31. Do you have a history of mental illness?

33. Have you ever cheated on a girlfriend?
34. Do you cook?
35. Do you have any siblings?
36. What is your religion?

38. Do you have piercings?
39. If so, how many, and where?
40. How many piercings do you have?
41. What is your current favorite movie of all time?
42. List your three favorite genres of music in order of most favorite to least favorite?:


43. What is your idea of a perfect date in three sentences or less?

44. Explain why I should pick you as my boyfriend / girlfriend in one sentence:

45. List any special skills that you may have that are relevant to this position:

46. What do you want out of a relationship, specifically one with me?


List the details of your past three relationships starting with the most recent.


Start Date:
End Date:
Were you in love?
Sexually active?
Reason for breakup:

Start Date:
End Date:
Were you in love?
Sexually active?
Reason for breakup:

Start Date:
End Date:
Were you in love?
Sexually active?
Reason for breakup:


I hereby certify that the information given by me in this application is true to my knowledge and I give you the authorization to verify it using any means you deem appropiate. I understand that by filling out this form and submitting it for review does not guarantee that I will be chosen.

Applicant Signature (type it in):

Do not write below this line, this area will be used to take notes when conducting interviews.

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