The Official Girlfriend Application
This application must be filled out in its entirety in order to be considered for the position that you are applying. Photographs or other
attached documents may sway my opinion one way or the other; feel free to attach anything you think may help you gain this position. Keep
in mind that you must be completely honest while filling out this form. Your answers will be checked through Google, twitter, Facebook, and
other methods I deem necessary. Any false information gives me the right to immediately void your application.
Section 1: Basic Information
Full name ______________________________________________________________________________________
LAST
FIRST
MIDDLE
Current Residence _______________________________________________________________________________
CITY
STATE
Nickname ________________________________________
ZIP
Age __________
Eye color _______________ Natural Hair Color _______________ Current Hair Color _______________
Height _______________ Weight (Circle One) <100lbs
101lbs – 175lbs
>175lbs
Section 2: Contact Information
Home Phone ____________________
Cell Phone ______________________
Email __________________________
Section 3: The Deal Breakers
Are you currently or have you ever been a man?
Yes
[ ]
No
[ ]
Do you smoke and/or use any other tobacco products?
[ ]
[ ]
Do you use any illegal substances?
[ ]
[ ]
Do you drink heavily on a regular basis? (>3 times/week)
[ ]
[ ]
Have you ever been convicted of anything by a court of law?
[ ]
[ ]
Would any of your actions with past boyfriends not be “John Approved”?
[ ]
[ ]
Section 4: Getting to Know You
Highest Level of Education (Circle One)
High School
Some College
College Graduate
What is your religious affiliation?____________________________________________________________________
What is your political persuasion? ___________________________________________________________________
Could you explain what said persuasion stands for? Y [ ] N [ ]
Do you have any siblings? Y [ ] N [ ]
If yes, list their names and ages _______________________________________________________________
What’s your all-time favorite movie? ________________________________________________________________
Are you easily distracted by shiny things? Y [ ] N [ ]
List your two favorite musical genres ________________________________________________________________
Favorite sport(s) and team(s) _______________________________________________________________________
Do you currently have a source of income? Y [ ] N [ ]
If yes, what is it? ___________________________________________________________________________
What kind of car do you currently drive? _____________________________________________________________
Section 5: Short Answer
Describe yourself using three to four adjectives and zero to one noun.
_______________________________________________________________________________________________
What is your idea of a perfect date? (In three sentences or less.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
What characteristics of mine lead you to apply for this position?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Explain why I should pick you as my girlfriend. (In one sentence.)
_______________________________________________________________________________________________
List any special skills you may have that is relevant to this position.
_______________________________________________________________________________________________
Section 6: Relationship Background
List the details of your past three relationships, starting with the most recent.
Name of Boyfriend:
Start Date:
Were you the (Circle One)
End Date:
Dumper
Dumpee
Reason for Breakup:
Name of Boyfriend:
Start Date:
Were you the (Circle One)
End Date:
Dumper
Dumpee
Reason for Breakup:
Name of Boyfriend:
Start Date:
Were you the (Circle One)
End Date:
Dumper
Dumpee
Reason for Breakup:
Section 7: References
Please supply three references and a way to contact them.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Section 8: Certification
I hereby certify that the information given by me in this application is true to the best of my knowledge, and I give you the
authorization to verify it using any means deemed appropriate. I understand that filling out this form and submitting it for
review does not guarantee that I will be chosen. I also understand that my information will not be released to independent
3rd parties and will only be viewed by the final judge(s).
Date: _____________________ Applicant Signature: _______________________________________________________