PART 1: DEMOGRAPHIC INFORMATION

NAME:
MSN Addy:
WEBSITE:
Skype:
CITY, STATE: COUNTRY:

PART 2: PERSONAL INFORMATION

MEASUREMENTS (OPTIONAL):
CURRENT OR COMPLETED EDUCATION LEVEL:
CURRENT OR INTENDED OCCUPATION:

PART 3: FACTS (PLEASE COMMENT ALL THAT APPLY)
I SMOKE
I DRINK
I HAVE CHILDREN
I AM/WAS IN A SORORITY/FRATERNITY
I KNOW WHAT FTP STANDS FOR
I LOVE SWEETS
I HAVE FORGOTTEN SOMEONE’S NUMBER BUT REMEMBERED THEIR EMAIL
I HAVE SPENT MORE THAN 60 DAYS IN PRISON
I’M A NYMPHOMANIAC
I NEED MORE THAN 6 HOURS OF SLEEP PER NIGHT
I OCCASIONALLY DO LIGHT DRUGS (E.G., MARIJUANA)
I OCCASIONALLY DO HARD DRUGS (E.G., EXTACY)
I HAVE BEEN APPROACHED BY MODELING AGENCIES
I CAN’T WAKE UP WITHOUT MY MORNING CAFFEINE
THERE IS AN ODOMETER ON MY BED
I’M A MEMBER OF A LAW ENFORCEMENT OR GOVERNMENT AGENCY
I HAVE A TONGUE, NOSE, OR BELLY BUTTON RING
I KNOW MY MOTHER’S DAUGHTER’S NAME
I TEND TO WAKE UP HOT AND BOTHERED
I HAVE TATTOOS

PART 4: SHORT ANSWER

WHY DO YOU THINK YOU ARE DATE MATERIAL?

WHAT ARE YOU LOOKING FOR IN A RELATIONSHIP?

IS THERE ANYTHING ELSE I SHOULD KNOW?