Application To Date Ashley Gauthier

             Name:                                                                                 .

            Birthdate/Age:                                                                   .

            Current Location:                                                             .

           Are you currently single?:                                                .

Top 5 Reasons you want to date Ashley:

Top 5 Reasons Ashley should choose you:

            List any special skills and/or “talents” you posses:

On a scale of 1-10, please answer the following questions:

1. How important is money to you in a relationship?           .

2. How important are looks in a potential mate?            .

3. Is a steady job in a potential mate a must have?            .

4. How important is maintaining your individuality while in a relationship?            .

5. How important is sex to you?            .

6. How willing to reciprocate are you?            .

7. How important are you friends in your life?            .

8. How important is your family in your life?            .

9. Do you have to be the most important thing in her life?            .

10. Is it important that decisions are made mutually?            .

Please list any and all Sexually Transmitted Diseases and/or venerial

diseases you currently have or have had in the past:

How many sexual partners have you had?:

1-2               3-4               4-5              6-7               8-9            

10+          ???/not sure/lost count

Do you expect sexy results on the first date? Why/why not?: