BASICS:
Name (last, first, middle, aliases): _____________________________
Age: ___
Hair Color: __________________
Eye Color: __________________
Height: __________
Weight: _________
Phone: ( ) ______ ___________
Email Address: _________________________________
Have two female acquaintances rate your looks, circling one number per evaluator, and obtain their signatures:
1 2 3 4 5 6 7 8 9 10
X______________________
1 2 3 4 5 6 7 8 9 10
X______________________
PREVIOUS EXPERIENCE:
Number of previous relationships: ____
Number of previous serious relationships: ____
Virgin? (Circle one): Yes No Questioning
If not, by what margin?: ____
Describe most recent ex (Leave blank if not applicable): _____________________
_______________________________________________________________________
Percentage of exes on good terms with (Leave blank if not applicable): ____%
INTELLECTUAL BACKGROUND:
Class Year: Freshman Sophomore Junior Senior
Highest level of education completed: _____________________
Major (if applicable): ____________________
Number of languages proficiently spoken or read: ______
Career (Or career plans): ________________________________________________
GENERAL:
Hours spent shopping in last six months: ____
Favorite movie: _________________________
Professed religious faith: _______________________
Describe your personality briefly: _________________________________________
________________________________________________________________________
________________________________________________________________________
Are you involved in sports?: Yes No Questioning
If so, which one(s)?: _____________________________________________________
________________________________________________________________________
Are you involved in a fraternity?: Yes No Questioning
If so, which one? Please briefly describe its purpose:_________________________
_______________________________________________________________________
Describe any leadership positions you have held: ___________________________
_______________________________________________________________________
_______________________________________________________________________
REFERENCES:
Please attach two letters of reference, preferably one from an ex, and provide contact information below (optional, but highly recommended):
Name: _________________________________________
Phone: ( ) ______ ___________
Email Address: _________________________________
Name: _________________________________________
Phone: ( ) ______ ___________
Email Address: _________________________________
SHORT ANSWERS:
Please answer two of the following questions in the space provided:
1. Where would you take me on a date, and what would we do?
2. In what ways do you show yourself a gentleman while on a date?
3. How might you make Valentine’s Day a memorable occasion?
_____________________________________________________________________________________________________
Thank you for your application! You will receive notification within 4-6 weeks, at which time an interview with a panel will be required.
Application written by Lauren Wilbanks, who will also be reviewing applications. ;-)
