Basic Info
First and Last Name *
Phone Number *
Email *
City *
State *
Date of Birth *
Height *
Occupation *
Are you authorized to work in the United States? *
Have you ever appeared on a TV show before? Please list name of show and date aired. *
Dating Experience
How many serious relationships have you been in and how long were they? What happened to end those relationships? *
Have you ever been married or engaged? If yes, why are you no longer together? *
Do you have any children? If yes, please list their names and ages and if they live with you or not. *
What is your type? *
Do you have any weird or interesting facts about you that you would usually wait to tell your significant other? *
Do you have any dating "deal breakers"? Please explain. *
What's the most over-the-top thing you've ever done to impress a date? *
Do you have any automatic turn-ons and/or turn-offs? *
What is something you hope never comes up on a date? *
About You
What's one thing we wouldn't know by looking at you? *
Explain the most life-changing event you've been through. *
List 3 things about you that would surprise us. *
What is the craziest thing that has ever happened to you? *
What's the most embarrassing thing that's ever happened to you? *
Instagram URL *
Facebook URL *
Please upload a recent photo that we can use as your profile picture! *
