First Name:

Last Name:

Email:

Age:

Birthday:

Location:

Height:

Weight:

Eye Color:

Hair Color:

Favorite Bands:

Favorite Movies:

Religion:
Christian Other

Drink?:
Often Sometimes Yes, but never get drunk Never

Smoke?:
Yes No Sometimes

What do you drive?:

Where do you work?:

What do you want to be when you grow up?:

Where do you see yourself in 5 years?:

Piercing:
Yes No
If yes, where?:

Tattoos:
Yes No
If yes, where?:

Why are you applying?:

What do you think is special about you?:

What do you think is special about me?:

What is your favorite body part of mine?:

Would you kiss me on our date?:
Yes No If things were going well

Would you want me in your bed?:
Yes No
Why or why not?:

Do you think I'm pretty?:
Yes No

On a scale from 1 to 10, 1 being ugly and 10 being amazingly beautiful, how would you rate me?:

Do you think we'd have more than one date?:
Yes No
Why or why not?

What are some of the things that you would do for me?:

What separates you from all other men?:

Any comments?: