Thank you for your interest in dating or fucking me. Due to the high volume of interested applicants, I will not be able to reply to all applications received. Allow four to six weeks for processing. A $10 processing fee may be imposed for incomplete or illegible applications. If any questions are left blank or unanswered, your application will be immediately disqualified.
**Respond to these questions, if you are only interested in fucking me. No further information is required of you beyond this. If other questions are answered on your part, your odds of being disqualified increase.
**Applicant’s First Name______________________
Last Name ________________________
Applicant’s Nickname(s) _____________________________
**Age _______ ** Height_____ **Weight______
Occupation _____________________________
Credit Score__________
Contact Information:
Address:__________________________________________City:__________________________Zip:____________________
**Phone number:_________________________________________Email address:_____________________________
Facebook alias (if applicable):________________________________Twitter handle:________________________
Answers to the following 2 questions could result in immediate disqualification from any position in my life, so think long and hard before completing your answer:
1. Please state specific reason(s) for your last breakup.
2. What is the best way to dominate Halo 2 and/or Call of Duty?
Lifestyle
3. Has a restraining order ever been filed against you?
4. Have you ever been convicted of a felony?
5. Do you currently have a valid driver’s license?
6. **Are you currently taking any medications?
7. Do you have piercings/tattoos? Please specify where and how many.
8. Do you wax, shave, or pluck any regions of your body?
9. Do you partake of recreation drugs? Which ones and how often?
10. Do you smoke cigarettes/cigars?
11. How many drinks do you consume on average on a weeknight?
12. How many drinks do you consume on average on a weekend?
13. What time do you wake up on weekends?
14. Which side of the bed do you prefer to sleep on?
15. How often do you travel for work?
16. Do you have a good relationship with your mother?
17. Is she prone to mood swings or currently taking anti-depressants?
Grooming
18. How much time do you spend looking in the mirror per day?
19. Does it take you longer than fifteen minutes to get ready?
Relationship History/Sexual Information
20. Have you ever been married?
21. How many “psycho” ex-girlfriends do you have?
22. How many exes are you still hooking up with?
23. When was the last time you had sexual intercourse? ___ a few hours ago ____a few days ago ____a few months ago ____a few years ago
24. How many porn subscriptions are currently in your name?
25. Have you ever undergone sexual reassignment surgery?
26. **Can you provide written documentation that you are free of STDs?
27. **Do you have any sexual dysfunctions that cannot be treated by a doctor?
28. How many one night stands have you had in the last six months?
29. On average, how many women do you sleep with at one time?
30. **Please specify and describe any fetishes.
31. **Are you a giver (and not necessarily in the financial sense)?
32. Check applicable sleep conditions: ___ sleep apnea ___bed wetting ___ sleep-walking ___sleep-talking ___random thrashing ____cover/bed hogging
33. **Have you ever dated any of my friends or family members?
34. Have you ever been suspected of cheating on a former girlfriend?
Random Important Crap
35. Will you dance?
36. Do you own cats?
37. Are you familiar with what a “douchecape” is? Do you own any?
38. Do you have children?
39. Do you like children?
40. Do you live alone or with a roommate?
41. Do you wear cologne? Please spray this form with the kind you are likely to wear on a date.
42. What is your preferred mode of communication? ___ text ___phone ___email ___IM ___Post-It note ____social networking site***
***Do Not Attempt to ‘Friend’ Me. If I wish to be your ‘friend,’ I will seek you out. Don’t make things awkward by ignoring this.
Additionally, please answer the following multiple choice questions:
43. How many times a week do you bathe/shower?
___ None (afraid of being sucked down the drain)
___ 1-3 (when flies mistake me for a pile of shit)
___ 4-6 (high hopes of getting intimate with someone)
___ 7 or more (have every brand of shower gel on the market and not enough days in a week to try them all)
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44. Do you leave brown stripes in your underwear?
___ Yes, I believe in conserving toilet paper.
___ No, I don’t wear underwear.
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45. How often do you wash your bedding?
**Answer if you are inclined to take me back to your place.
___ Daily (must be a nympho)
___ Once a week (at the carwash)
___ Yearly (when I get my tax refund)
___ Never (haven’t brought a date home in years)
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47. What are your shopping habits?
___ I prefer shopping at garage sales. (leaves more money to buy my booze with)
___ I prefer shopping at discount stores. (can buy ten times more junk food for less)
___ I prefer shopping at the mall. (great place to check out cute butts)
___ I prefer to shop at all the finer stores (until all the credit cards are maxed out)
___ I don’t pay for anything, I just take it. (don’t bother completing the rest of this application)
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48. You are sitting in your recliner watching television and sneeze a juicy one, what do you do?
___ Wipe my nose on my sleeve then give someone a great big hug.
___ Wipe my nose with the remote.
___ Yell for someone to bring me a tissue, then hide/stuff it down the chair when I’m done with it.
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49. You are cuddling with your sweetheart in bed and feel gas pressure building, what do you do?
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___ Excuse myself and make a mad dash to the bathroom.
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___ Let it blow and brag about how I made the windows shake.
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___ Blast the stink bomb then toss the covers over her head. Dutch Oven of Love.
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___ Let it leak out silently and blame it on the dog.
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50. The toilet breaks and needs repaired, what do you do?
___ Get the duct tape out and fix it myself.
___ Wait and see if it will miraculously fix itself.
___ Hire someone to fix it.
___ Choose to do nothing and use the gas station’s restroom for the rest of the year.
51. How do you feel about washing dishes?
___ Love playing in bubbles and beg for people to dirty more dishes.
___ Only when company is coming.
___ Out of the question, I might break a nail.
___ I’m allergic to dish soap.
___ I consider dirty dishes to be a work of art and stack them all over the house/apt. as decorations.
52. How do you feel about mowing the lawn and misc. yard work?
___ Can’t wait to get the rider out so I can chase the neighbor’s cat around the yard.
___ Hire a lawn care company.
___ Just set it on fire once a year.
___ Do nothing at all, I enjoy living in a jungle.
___**I will mow your lawn for a blow job.
53. Which best describes your cooking?
___ I must be an excellent cook because everyone I know eats at my house.
___ I burn everything and the dog refuses to eat it.
___ I have all the delivery places on speed dial.
___ I don’t cook, I have my own personal chef.
55. You are driving down the highway and notice your ex’s car pulled over with a flat tire,
what do you do?
___ Pull over and grab my old cd player out of the car while they are changing the flat.
___ Drive by and act like I don’t see them.
___ Blow the horn and yell out the window “It sucks to be you”.
56. Describe your perfect first date.
Please attach one current (date stamped) picture**, baby picture, three references, and a copy of your current immunization records. Self-photography is not permitted for the purposes of this application. Any pictures taken of oneself will result in immediate disqualification. If you submit a photo taken of you by you, I assume you have no friends to take your picture and there for do NOT want to date you anyway.
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I hereby attest and verify that the information I have provided in this application is absolutely false and misrepresented. I understand that any honest or true answers could lead to me spending the rest of my life (**or at least the night) alone.
Sign:_________________________________________________ Date:___________________________
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