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  Relationship Application
  CONTACT INFORMATION
Name    Real Name   
Cell Phone    Facebook   
Email    Real email   
Position Sought Companion FWB Mistress Girl Friend Live-in Spouse
  MAINTENANCE LEVEL  
  Least (Circle answer) Most
General Needs None Low Average Needy High Very High
Dinning Cook Fast Food Chains Fine Dining Five Star My Chef
Travel Lodging Camping Motel 6 Radisson Hilton Four Seasons My Villa(s)
Transportation Walk Bus Train Southwest First Class My Jet(s)
Child Care None Family Baby Sitter Stay-Over Live-in My Staff
Shopping 99 Cent Target Macys Nordstrom Neimans My Seamstress
Vehicle Bus Ford Camry BMW Bentley Limo w/ Driver
Household Help No way Rarely Monthly Weekly Every Day My Servants
Gifts Flower Bouquet Clothes Trip Car Van Cleef
Spa Why Rarely As needed Monthly Weekly My Masseuse
In addition to all of the above I need $_____,_____,_____ per week to cover out of pocket expenses.
  BACKGROUND  
Are you/have you ever been a man? Y / N Have you had a restraining order issued against you? Y / N
Are you currently in a relationship? Y / N Have you had a restraining order issued against anyone? Y / N
Do you often drink heavily? Y / N Have you had cosmetic surgery more than once? Y / N
Do you use any illegal substances? Y / N Are you looking for a man to "fix" or "improve"? Y / N
Do you have large visible tattoos? Y / N Disregarding your ears, do you have any piercings? Y / N
Do you whistle on a regular basis? Y / N Do your ear piercings set off metal detectors? Y / N
Are you in debt over $2,000? Y / N Have you had a child while unmarried? Y / N
Do you just want to be "friends"? Y / N Have you ever been convicted by a court of law? Y / N
Have you ever stalked someone? Y / N Do you have male 'Friends" who are not gay? Y / N
Do you have an STD? Y / N Do you call your mom more than once a week? Y / N
Do you feel a need to have a child? Y / N Does anyone have videos/pictures of you having sex? Y / N
Do you smoke? Y / N Do you often burst into tears for no reason? Y / N
If you answered "Yes" to any of the previous questions, we are not currently interested in your services. 
GENERAL CHARACTERISTICS
    Dating Site Barefoot CFM Heels Ethnicity
Height         Nordic Goddess Exotic
    Dating Site Will Admit to: Actual: Alluring Asian Gorgeous Indian
Age         Exquisite European Polynesian Princess
Weight         Divine African Fiery Latin
No. of Children         Magnificent Mediterranean
On a scale of 1 to 10, I am a       Other:  
Described Body Style       Totally Hot, Who Cares  
(Body styles; Athletic-Toned-Fit-Average-HWP-Few Extra-Heavy-Curvy-Total Porker)    
PREVIOUS RELATIONSHIPS
Name (His) Income Started/Ended Ended by? Still Obsessed? Refer. Avail? Why Ended
    /        
    /        
    /        
(Please list all relationships in the last 20 years - attach additional sheet(s) as needed)      
PERSONALITY
  Least (Circle answer) Most
Education Public Elementary Middle High School College Masters/PHD
Manners I belch Use spoon Use Fork/Spoon Right Fork Correct Spoons Can Set Table
Science Cut Class Heard of it Forgot Most Know Sum Use it Daily Quantum Theorist
Intelligence Room Temp Summer Day Hot Desert Beef Medium Poultry Boiling water
Politics Hope/Change Unfamiliar Heard of it Always vote Active Lobby often
Religion Too Early Heard of it Rarely Often Every Week Everyday
Culture Sports Yogurt Swap Meets Museums Theater Opera Often
Verbal Don't do that Outspoken Loquacious Well Spoken Eloquent Orator
Clingy Still here? Weekly Daily Hourly Minute Overbearing
Summary I'm Totally Hot, Who Cares Presents Well Highly Potty Trained
Circle Answer (Rating scale is; 1 least or disagree to 9 most or agree)
Appreciate art and culture 1 2 3 4 5 6 7 8 9 Calm and resilient 1 2 3 4 5 6 7 8 9
Communicate innermost feelings 1 2 3 4 5 6 7 8 9 Like to learn 1 2 3 4 5 6 7 8 9
Community service (not part of parole) 1 2 3 4 5 6 7 8 9 Earn an income 1 2 3 4 5 6 7 8 9
Cook for family and friends 1 2 3 4 5 6 7 8 9 New adventures 1 2 3 4 5 6 7 8 9
Create solutions to everyday problems 1 2 3 4 5 6 7 8 9 Organize and schedule 1 2 3 4 5 6 7 8 9
Create everyday problems 1 2 3 4 5 6 7 8 9 Raise/care for children 1 2 3 4 5 6 7 8 9
Decorate (other than just being in room) 1 2 3 4 5 6 7 8 9 Romantic 1 2 3 4 5 6 7 8 9
Do Improvements/Repairs 1 2 3 4 5 6 7 8 9 Sense of humor 1 2 3 4 5 6 7 8 9
Release/ renew IP connection 1 2 3 4 5 6 7 8 9 Think outside the box 1 2 4 3 5 8 6 7 9
Know what an IP connection is 1 2 3 4 5 6 7 8 9 Teaches Others 1 2 3 4 5 6 7 8 9
Understands world events 1 2 3 4 5 6 7 8 9 Simple things please me 1 2 3 4 5 6 7 8 9
Help the less fortunate (if any) 1 2 3 4 5 6 7 8 9 I'm Totally Hot, Who Cares 1 2 3 4 5 6 7 8 9
STATISTICS VISUAL ATTACHMENTS
    Dating Site Will Admit to: Actual: Please attach full length
No. of Marriages       front (with face) and rear views
No. of Men slept with       of you attired in:
No. of Men at the same time       Evening Gown Favorite LBD
No. of women slept with       Semi-Formal Business Attire
Number of Children       Summer Dress Shorts/Casual
Number of Different Fathers       Lingerie & Heels No Couture
Golf Handicap          
Tennis Rating          
PHRF rating of your Yacht       Photos should be from your current modeling
World Ranking ________sport       portfolio, and less than six months old
PHYSICAL ATTRIBUTES
  Smallest (Circle answer) Largest
Head Softball Small Proportional Awesome Basketball Pumpkin
Neck Pencil Delicate Thin Awesome Bulging Weight Lifter
Shoulders Tiny Petite Ballerina Awesome Swimmers Line Backer
Waist  Wasp Slim Nice Awesome Bulging Porker
Legs Tree Stumps Short Average Awesome Long Forever
Hip Tight Slim Awesome Got Back Junk in Trunk Fat Ass
Thigh Pencils Thin Average Awesome Tree Trunk Thunder
Calves Toothpicks Delicate Thin Awesome Bulging Weight Lifter
Feet Tiny Petite Small Awesome Big Sasquatch
Bust Girlish Petite Awesome Stacked Amazing Too Much
Cup Size A B C D DD OMG
HAIR
  Color(s) Shortest (Circle answer) Longest
Head   Dykish Neck Shoulders Mid Back Awesome
Face   None Shaped Trimmed Natural Jungle
Eyebrows   Shaved Shaped Trimmed Natural Unibrow
Underarm   None Shaped Trimmed Natural Jungle
Chest   None Shaped Trimmed Natural Jungle
Legs   None Shaped Trimmed Natural Jungle
Down there   None Shaped Trimmed Natural Jungle
PERSONAL PREFERENCES
  Least (Circle answer) Most
Too Often is? Never Monthly Weekly 2+ per Week Daily 2+ per Day
Experiment? Never Monthly Weekly 2+ per Week Daily 2+ per Day
Lingerie/Heels Never 2 Years Yearly Monthly Weekly 2+ per Day
Oral; Receive Never Monthly Weekly 2+ per Week Daily 2+ per Day
Oral; Give Never Monthly Weekly 2+ per Week Daily 2+ per Day
Toys Never 3 Years Yearly Monthly Weekly 2+ per Day
Backdoor Never Monthly Weekly 2+ per Week Daily 2+ per Day
Foods/Sauces Never Monthly Weekly 2+ per Week Daily 2+ per Day
Oils Never 2 Years Yearly Monthly Weekly 2+ per Day
Blindfolds Never 2 Years Yearly Monthly Weekly 2+ per Day
Oral; Advanced Never Monthly Weekly 2+ per Week Daily 2+ per Day
Lite Spanking Never 2 Years Yearly Monthly Weekly 2+ per Day
Mirrors Never 2 Years Yearly Monthly Weekly 2+ per Day
Take Pics/Vids Never 2 Years Yearly Monthly Weekly 2+ per Day
Role Playing Never 2 Years Yearly Monthly Weekly 2+ per Day
Sub/Dom Game Never 2 Years Yearly Monthly Weekly 2+ per Day
Too many is 1 2 3 4 5 >10
This List is Sick Perverted Odd Kinky Fun Incomplete

 

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