The Official Girlfriend Application

This application must be filled out in its entirety in order to be considered for the position that you are applying. Photographs or other
attached documents may sway my opinion one way or the other; feel free to attach anything you think may help you gain this position. Keep
in mind that you must be completely honest while filling out this form. Your answers will be checked through Google, twitter, Facebook, and
other methods I deem necessary. Any false information gives me the right to immediately void your application.

Section 1: Basic Information

Full name ______________________________________________________________________________________

LAST FIRST MIDDLE

Current Residence _______________________________________________________________________________

CITY STATE ZIP

Nickname ________________________________________ Age __________

Eye color _______________ Natural Hair Color _______________ Current Hair Color _______________

Height _______________ Weight (Circle One) <100lbs 101lbs 175lbs >175lbs

Section 2: Contact Information

Home Phone ____________________

Cell Phone ______________________

Email __________________________

Section 3: The Deal Breakers

Yes No
Are you currently or have you ever been a man? [ ] [ ]

Do you smoke and/or use any other tobacco products? [ ] [ ]

Do you use any illegal substances? [ ] [ ]

Do you drink heavily on a regular basis? (>3 times/week) [ ] [ ]

Have you ever been convicted of anything by a court of law? [ ] [ ]

Would any of your actions with past boyfriends not be John Approved? [ ] [ ]
Section 4: Getting to Know You

Highest Level of Education (Circle One) High School Some College College Graduate

What is your religious affiliation?____________________________________________________________________

What is your political persuasion? ___________________________________________________________________

Could you explain what said persuasion stands for? Y [ ] N [ ]

Do you have any siblings? Y [ ] N [ ]

If yes, list their names and ages _______________________________________________________________

Whats your all-time favorite movie? ________________________________________________________________

Are you easily distracted by shiny things? Y [ ] N [ ]

List your two favorite musical genres ________________________________________________________________

Favorite sport(s) and team(s) _______________________________________________________________________

Do you currently have a source of income? Y [ ] N [ ]

If yes, what is it? ___________________________________________________________________________

What kind of car do you currently drive? _____________________________________________________________

Section 5: Short Answer

Describe yourself using three to four adjectives and zero to one noun.

_______________________________________________________________________________________________

What is your idea of a perfect date? (In three sentences or less.)

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

What characteristics of mine lead you to apply for this position?

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Explain why I should pick you as my girlfriend. (In one sentence.)

_______________________________________________________________________________________________

List any special skills you may have that is relevant to this position.

_______________________________________________________________________________________________
Section 6: Relationship Background

List the details of your past three relationships, starting with the most recent.

Name of Boyfriend:

Start Date: End Date:

Were you the (Circle One) Dumper Dumpee

Reason for Breakup:

Name of Boyfriend:

Start Date: End Date:

Were you the (Circle One) Dumper Dumpee

Reason for Breakup:

Name of Boyfriend:

Start Date: End Date:

Were you the (Circle One) Dumper Dumpee

Reason for Breakup:

Section 7: References

Please supply three references and a way to contact them.

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Section 8: Certification

I hereby certify that the information given by me in this application is true to the best of my knowledge, and I give you the
authorization to verify it using any means deemed appropriate. I understand that filling out this form and submitting it for
review does not guarantee that I will be chosen. I also understand that my information will not be released to independent
3rd parties and will only be viewed by the final judge(s).
Date: _____________________ Applicant Signature: _______________________________________________________