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, twitter, 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

STATE

Nickname ________________________________________

ZIP

Age __________

Eye color _______________ Natural Hair Color _______________ Current Hair Color _______________ Height _______________ Weight (Circle One) <100lbs

101lbs – 175lbs

>175lbs

Section 2: Contact Information Home Phone ____________________ Cell Phone ______________________ Email __________________________ Section 3: The Deal Breakers

Are you currently or have you ever been a man?

Yes [ ]

No [ ]

Do you smoke and/or use any other tobacco products?

[ ]

[ ]

Do you use any illegal substances?

[ ]

[ ]

Do you drink heavily on a regular basis? (>3 times/week)

[ ]

[ ]

Have you ever been convicted of anything by a court of law?

[ ]

[ ]

Would any of your actions with past boyfriends not be “John Approved”?

[ ]

[ ]

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? Y [ ] N [ ] Do you have any siblings? Y [ ] N [ ] If yes, list their names and ages _______________________________________________________________ What’s your all-time favorite movie? ________________________________________________________________ Are you easily distracted by shiny things? Y [ ] N [ ] List your two favorite musical genres ________________________________________________________________ Favorite sport(s) and team(s) _______________________________________________________________________ Do you currently have a source of income? Y [ ] N [ ] If yes, what is it? ___________________________________________________________________________ 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 lead you to apply for this position? _______________________________________________________________________________________________ _______________________________________________________________________________________________ Explain why I should pick you as my girlfriend. (In one sentence.) _______________________________________________________________________________________________ List any special skills you may have that is relevant to this position. _______________________________________________________________________________________________

Section 6: Relationship Background List the details of your past three relationships, starting with the most recent. Name of Boyfriend: Start Date: Were you the (Circle One)

End Date: Dumper

Dumpee

Reason for Breakup:

Name of Boyfriend: Start Date: Were you the (Circle One)

End Date: Dumper

Dumpee

Reason for Breakup:

Name of Boyfriend: Start Date: Were you the (Circle One)

End Date: Dumper

Dumpee

Reason for Breakup:

Section 7: References Please supply three references and a way to contact them. _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 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: _____________________ Applicant Signature: _______________________________________________________