Personal

First Name*

Last Name*

Nickname

Gender Male Female

D.O.B - Date of Birth requested for verification purposes only pursuant to 18 U.S.C. §§ 2256 et seq. 1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031

Hair Color (e.g. Blonde hair)

Eye Color (e.g. Blue eyes)

Contact Information

Address

City*

State (Province) AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingBritish ColumbiaAlbertaSaskatchewanManitobaOntarioQuebecNew BrunswickNova ScotiaPrince Edward islandNewfoundland & LabradorNorthwest TerritoriesYukon TerritoriesNunavut

Zip (Postal) Code

Home Phone

Work Phone

Mobile*

Email*

Website

Facebook / Twitter / Other

Hometown City

YouTube URL

Current City Residence

Education / Employment Information

Education Completed

School Attended

Degree

Occupation

Time at current job

Show Questions

DO YOU DATE MEN OR WOMEN?:

WHERE DID YOU GROW UP AND HOW DID IT INFLUENCE YOU?:

WHAT MAKES YOU UNIQUE?:

HOW WOULD YOU DESCRIBE YOUR PERSONALITY?:

WHAT ARE YOUR HOBBIES?:

DESCRIBE YOUR PERFECT DAY OFF:

WHERE ARE YOUR FAVORITE HANGOUT?:

WHAT ARE YOUR 3 FAVORITE MOVIES?:

DESCRIBE YOUR MOST EMBARRASSING MOMENT OR EXPERIENCE:

DO YOU HAVE ANY SPECIAL TALENTS?:

WHY ARE YOU SINGLE?:

WHAT MAKES YOU A GREAT CATCH?:

WHAT ARE YOU LOOKING FOR WHEN IT COMES TO DATING OR A RELATIONSHIP?:

WHAT ARE YOUR DEAL BREAKERS/PET PEEVES WHEN IT COMES TO THE PERSON YOU ARE DATING?:

WHAT IS THE MOST ROMANTIC THING YOU HAVE DONE FOR SOMEONE YOU WERE DATING?:

DESCRIBE THE TYPE OF PERSON YOU USUALLY DATE:

ARE YOU NORMALLY ATTRACTED TO A CERTAIN ETHNICITY? IF YES, WHICH:

WHAT AGE RANGE DO YOU USUALLY DATE?:

DESCRIBE YOUR TYPICAL FIRST DATE:

HOW WILL YOUR TYPICAL DATE USUALLY END? HUG, KISS, SEX, HAND SHAKE, ETC. AND WHAT DICTATES HOW IT WILL END?:

TELL US ABOUT THE BEST DATE YOU HAVE BEEN ON:

TELL US ABOUT THE WORST DATE YOU HAVE EVER BEEN ON:

IS THERE ANYTHING INTERESTING WE SHOULD KNOW ABOUT YOU?:

DESCRIBE YOUR CURRENT LIVING SITUATION (i.e. roommates, parents, etc.):

LIST ALL STATES WHERE YOU HAVE LIVED: