Girlfriend Application For Keith .pdf
Original filename: Girlfriend Application For Keith.pdf
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Girlfriend Application For Keith
City ST ZIP Code
During which hours are you available to go on dates?
___ Weekday mornings
___ Weekend mornings
___ Weekday afternoons
___ Weekend afternoons
___ Weekday evenings
___ Weekend evenings
Tell us in which areas you are interested in as a date
___ Fancy Dinner
___ A Walk on the Beach
___ Simply Hangout
___ Cuddle up and stay in
___ Hit the gym
___ Go shopping
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from dating,through other activities,
including hobbies or sports.
Previous Dating Experience
Summarize your previous Dating experience.
Person to Notify in Case of Emergency
City ST ZIP Code
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand
that if I am accepted as a girlfriend, any false statements, omissions, or other misrepresentations
made by me on this application may result in my immediate dismissal.
It is the policy of this organization to provide equal opportunities without regard to race, color, religion,
national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in dating with me.