Boyfriend Application
Pre-dating questionaire



Your NAME: Date of Birth:

Your Email:

Webpage address:

Where are you from(what state)
Height:

Weight:

Eyes:
Blue Brown Green Hazel Grey Bloodshot I have two of them They are crossed

Hair Color:

If other, please specify:

Education:

If other, please specify:

Current living status?

When is your curfew for a first date?

What would you expect on a first date?
I'm unavailable for a date A handshake A kiss at the door Light petting Your place or mine? Pure Ecstasy If it's the right person, anything could happen

Do you have a job?
Yes
No

Annual Income
Less than $20,000 $20,001 - $30,000 $30,001 - $40,000 $40,001 - $50,000 $50,001 - $60,000 $60,001 - $75,000 $75,001 - $100,000 I get paid by the trick! I though you had a job.

Do you drink?:
I do not drink
I drink socially
I drink daily
I am a fish
Only when I have to dance
Fish don't even invite me over for drinks!

Do you smoke?:
I do not smoke
I smoke socially
I smoke daily
I am a chimney
Only when I have to drink
Me and Camel Joe are best friends!

How would you describe your appearance?
Very good looks Above average looks Average looks I have my bumps and bruises I am road kill I have caused road closures

Do you have any body art(tattoos)?
Yes No
Please explain:

Do you have any body piercings?
Yes No
What and Where:

Do you use drugs?:
Yes No
Only for pain

Are you a virgin?
Yes No
If no, how many partners?

Any interesting hobbies?

Are you going to look for a committment after a week?
Yes
No

How would you describe yourself?

Astrologial Sign:

Do you borrow clothes?
Yes
No

Preferred Relationship:
Casual Open-ended Love-Hate Friends Committed Purely Sexual Codependent

Former Girlfriends: list below your last three girlfriends, starting with the last one first.

1. Dates (month & year ) From: to:
NAME Email:
Position:
Reason for leaving:

2. Dates (month & year ) From: to:
NAME Email:
Position:
Reason for leaving:

3. Dates (month & year ) From: to:
NAME Email:
Position:
Reason for leaving:
Do you currently have a girlfriend? Yes No
If Yes, may I inquire with her? Yes No

Position Desired:
Date you can start:

Authorization:

I certify that the information contained in this application is true to the best of my knowledge. I understand any information found to be untrue terminates any further consideration. I grant permission to contact references and ex's listed. I also release any liability to the parties contacted.

check box to agree with the above statement