Boyfriend Application
Basic information:
Name:
You are:
Male
Female
Your birthdate:
Have we met in person?
Yes
No
Do you smoke?
Yes
No
What position are you applying for?
Boyfriend
Friend with benefits
Lesbian lover
Just friends
Fuck buddy
Past relationships:
How many different people have you had sex with?
0-1
2-4
5-7
8-10
More than 10
Have you ever had... (please check all that apply)
Crabs
Syphilis
Chlamydia
Gonorrhea
Genital Warts
Herpes
HIV/AIDS
Do you currently have... (please check all that apply)
Crabs
Syphilis
Chlamydia
Gonorrhea
Genital Warts
Herpes
HIV/AIDS
Personality
Please list your intrests below:
examples: reading, sports, long walks on the beach, etc
Political affiliation:
Democrat
Republican
Independent
Other
None
Do you like to talk about politics?
Yes
No
Sometimes
What is your religion?
Jewish
Catholic
Christian
Buddist
Wiccan
Agnostic
Atheist
Scientologist
Muslim
Other
Other information
Do you have a job?
Yes
No
If yes, what is it?:
If no, please explain:
Do you have a car?
Yes
No
Contact information
MySpace Username:
Phone number:
Email address:
Comments: