MARRIAM CHAFERA BOYFRIEND APPLICATION
Email address *
Full legal name: *
Your answer
Instagram/Twitter/Facebook *
Your answer
Age *
Your answer
Height *
Your answer
Weight *
Your answer
Eye color *
Your answer
Hair color *
Your answer
Getting to know you
Are you a virgin? *
If no to above question, how many sexual partners have you had? *
Do you smoke? *
Do you have kids? *
Do you work out? *
Do you currently have a source of income? *
If so, what do you do? *
Your answer
Do you live on your own? *
What kind of car do you drive? *
Your answer
Do you cook? *
Favorite sport & team? *
Your answer
Highest level of education *
Have you ever cheated on a girlfriend? *
Relationship Background
List the details of your past relationships starting with most recent
Relationship 1: Start Date *
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DD
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YYYY
Relationship 1: End Date *
MM
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DD
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YYYY
Relationship 1: Were you in love? *
Relationship 1: Am I prettier? *
Relationship 1: Reason for breakup? *
Your answer
CERTIFICATION
I hereby certify that the information given by men in this application is true to my knowledge. I understand that by filling out this form and submitting it for review does not guarantee I will be chosen.
Date *
MM
/
DD
/
YYYY
Signature *
Your answer
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