COUPLE’S CORNER APPLICATION FORM
Couple's Corner 237 is here with its concept and objective to curb social contemporary problems in our society and country Cameroon. The reality TV show will help reduce the rate of broken homes, divorce rates, single parenting, tribalism, cohabitation, balancing home and work life, lack of communication, alcohol abuse, gender base violence, domestic violence, sexual abuse, financial issues in relationships, street children and proper family planning.
Sign in to Google to save your progress. Learn more
PERSONAL INFORMATION
Name *
First & Last Name
Nickname *
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth *
Nationality *
Region of origin *
Village of origin *
Occupation *
Father's Name
Mother's Name
Gender *
Marital Status *
Are you into any serious relationship? *
Required
Do you want to go in as couples? *
Required
What do you do for a living? *
Country of residence *
Region of residence *
Are you coming to the house as a SINGLE or COUPLE? *
CONTACT DETAILS
Email *
Phone *
Social Media Handles
Facebook
Instagram
Twitter
WhatsApp number or link *
Brief description of self *
Hobbies *
BRIEF DESCRIPTION OF PARTNER YOU WANT
Height
Complexion
Size
Spoken Languages
NB
- Non refundable application fee of 10.000FrsCFA / 8.000 Naira for Cameroonians & Nigerians respectively.
- Participation fee of 50.000FrsCFA / 40.000 Naira for Cameroonians & Nigerians respectively.
- Contestants MUST upload or attach a full pic, passport size image and a video of 30 SECONDS giving reasons why he/she wants to go into the "Love Mansion".
- Each Contestant will be opened an account of 50.000FrsCFA / 40.000 Naira to all couples from Cameroon & Nigeria respectively going into the love mansion and will be increased progressively as you stay longer in the house.
- All payments should be made via our MoMo or Orange Money Accounts (678640128 or 693205926) and a screenshot of the transaction should be sent to Couple'scorner 237 via mail couplescorner21@gmail.com or in our office located 355, Akwa Rue Alfred Saker, Behind Orca Akwa, Enonchong Building, 1st floor.


Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy