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The Official Girlfriend Application

This application must be filled out in its entirety GI Just a reminder: be completely honest with

in order to be considered for the position that you all your answers, I will be double checking

are applying. Photographs may sway my opinion applications using Google to ensure honesty. Any
one way or the other, feel free to attach any that O false information will automatically nullify any

you think may help you gain this position. chance you might have had. Thanks, and have fun.


1. Full legal name

Last First Middle

2. Age 3. Height 4. Weight 5. Eye color

6. Measurements 3. Natural hair color 4. Current hair color


9. Home phone ( ) - 10. Cell Phone ( ) -

11. Email


12. Are you a virgin? Y N 13. If no, how many past sexual partners have you had?

14. Have you ever had a sex change? Y N 15. Do you smoke? Y N 16. Do you use any

illegal substances? Y N 17. Do you have kids? Y N 18. If yes, how many?

19. Do you workout? Y N 20. Do you currently have a source of income? Y N 21. If yes,

what is it? 22. Do you live on your own? Y N 23. If no, whom

do you currently reside with? 24. What kind of car do you drive?

25. Furthest level of edumacation (circle one): High School Some College Associate’s Degree Bachelor’s Degree

26. Do you have a history of mental illness? Y N 27. Favorite sport & team

28. Have you ever cheated on a boyfriend? Y N 29. Do you cook? Y N

Copyright © 2005 Brody Vercher.

30. Do you have any siblings? Y N 31. What is your religion?

32. What is your political persuasion 33. How many piercings (not including ears) do

you have? 34. How many tattoos do you have? 35. What is your current

favorite movie of all time?

36. List your three favorite genres of music in order of most favorite to least favorite:


37. What is your idea of a perfect date in three sentences or less?

38. Explain why I should pick you as my girlfriend in one sentence:

39. List any special skills that you may have that are relevant to this position:

40. What do you want out of a relationship, specifically one with me?

Copyright © 2005 Brody Vercher.

List the details of your past three relationships starting with the most recent.
Start Date: End Date:
Were you in love? Y N Could I kick his ass? Y N
Sexually active? Y N Reason for breakup:

Start Date: End Date:

Were you in love? Y N Could I kick his ass? Y N
Sexually active? Y N Reason for breakup:

Start Date: End Date:

Were you in love? Y N Could I kick his ass? Y N
Sexually active? Y N Reason for breakup:

Please supply three references (preferably hot female friends) and their phone numbers or email addresses.

I hereby certify that the information given by me in this application is true to my knowledge and I give you the
authorization to verify it using any means you deem appropiate. I understand that by filling out this form and
submitting it for review does not guarantee that I will be chosen.

Date Applicant Signature

Do not write below this line, this area will be used to take notes when conducting interviews.

Copyright © 2005 Brody Vercher.

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