other methods I deem necessary. Any false information gives me the right to immediately void your application. Section 1: Basic Information. Full name ...
INT. THE LIVING ROOM. SCOTTY blinks. Sees a unconscious Shannon. He
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Home phone. 10. Cell Phone. 11. Email. ( ) -. ( ) -. BASIC INFORMATION. 12. Are you a virgin? Y N 13. If no, how many past sexual partners have you had?
regarding this NCBA OFFICIAL CUDDLE BUDDY APPLICATION (Form R1A), hereby acknowledging that it will only be used in such
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Copyright 2007 Pacific Magazines. All rights reserved. Last Update : 10-Jan-
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Would any of your actions with previous boyfriends be considered not “Beth.
The Official Girlfriend Application This application must be filled out in its entirety in order to be considered for the position that you are applying. Photographs or other attached documents may sway my opinion one way or the other; feel free to attach anything you think may help you gain this position. Keep in mind that you must be completely honest while filling out this form. Your answers will be checked through Google, MySpace, Facebook, and other methods I deem necessary. Any false information gives me the right to immediately void your application.
Section 1: Basic Information Full Name ____________________________________________________________ Last
First
Middle
Current Residence ______________________________________________________ City
Nickname _______________ Eye Color ______ Height ______
State
Zip
Age _____
Natural Hair Color __________ Weight (Circle One) 100 & 175
Section 2: Contact Information Home Phone ____________________ Cell Phone _____________________ IM Name (Please specify service, AIM preferred) _____________________ Email __________________________ Section 3: The Deal Breakers Yes No
Are you or have you ever been a man? Do you smoke and/or use other tobacco products? Do you drink heavily on a regular basis? Do you use any illegal substances? Do you have any tattoos? Do you whistle on a regular basis? Would any of your actions with previous boyfriends be considered not “Beth Justin Approved”? Disregarding your ears, do you have any piercings? Regarding your ears, are they gauged larger than 1/16th of an inch and/or might they set off metal detectors at airports or government buildings? Have you ever been convicted of anything by a court of law? If you answered “Yes” to any of the previous questions, you may stop filling out the application now as we are not currently interested in your services. 1
Section 4: Getting to Know You Highest level of education (Circle One) High School Some College College Graduate What is your religious affiliation? _________________________________________________ What is your political persuasion? _________________________________________________ Could you explain what said persuasion stands for? Do you have any siblings?
Y
Y
N
N
If yes, list their names and ages. ____________________________________________ What’s your all-time favorite movie? ______________________________________________ I’ve seen: (Circle all that apply) The Matrix Trilogy Serenity
All 6 Star Wars Any season of Red vs. Blue
Are you easily distracted by shiny things? Y
N
List your 2 favorite musical genres. _______________________________________________ Favorite sport and team (If any) __________________________________________________ Do you ski / snowboard or would you be willing to learn? Y Do you currently have a source of income? Y
N
N
If yes, what is it? ________________________________________________________ Your thoughts on time travel? ____________________________________________________ What kind of car do you currently drive? ___________________________________________ Section 5: Short Answer Describe yourself using three to four adjectives and zero to one noun. ____________________________________________________________________________ What is your idea of a perfect date, in three sentences or less? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ What characteristics of mine led you to apply for this position? ____________________________________________________________________________ ____________________________________________________________________________ Explain why I should pick you as my girlfriend in one sentence. ____________________________________________________________________________ List any special skills you have that may be relevant to this position. ____________________________________________________________________________ ____________________________________________________________________________ 2
Section 6: Relationship Background List the details of your past three relationships, starting with the most recent. Name of Boyfriend: Start Date:
End Date:
Were you the: (Circle one) Dumper Dumpee Reason for breakup: Name of Boyfriend: Start Date:
End Date:
Were you the: (Circle one) Dumper Dumpee Reason for breakup: Name of Boyfriend: Start Date:
End Date:
Were you the: (Circle one) Dumper Dumpee Reason for breakup: Section 7: References Please Supply three references and their contact information (Phone, IM, and/or Email). ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Section 8: Certification I hereby certify that the information given by me in this application is true to the best of my knowledge, and I give you the authorization to verify it using any means deemed appropriate. I understand that filling out this form and submitting it for review does not guarantee that I will be chosen. I also understand that my information will not be released to independent 3rd parties and will only be viewed by the final judge(s). Date: _____________