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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, MySpace, Facebook, and other methods I deem necessary.

Any false information gives me the right to immediately void your application.

Section 1: Basic Information

Section 2: Contact Information

Section 3: The Deal Breakers

Full Name ____________________________________________________________

Last First Middle

Current Residence ______________________________________________________

City State Zip

Nickname _______________ Age _____

Eye Color ______ Natural Hair Color __________ Current Hair Color __________

Height ______ Weight (Circle One) <100 lb >100 & <175 >175

Home Phone ____________________

Cell Phone _____________________

IM Name (Please specify service, AIM preferred) _____________________

Email __________________________

If you answered “Yes” to any of the previous questions, you may stop filling

out the application now as we are not currently interested in your services.

Are you or have you ever been a man?

Do you smoke and/or use other tobacco products?

Do you drink heavily on a regular basis?

Do you use any illegal substances?

Do you have any tattoos?

Do you whistle on a regular basis?

Would any of your actions with previous boyfriends be considered not “Beth

Justin Approved”?

Disregarding your ears, do you have any piercings?

Regarding your ears, are they gauged larger than 1/16th

of an inch and/or

might they set off metal detectors at airports or government buildings?

Have you ever been convicted of anything by a court of law?

Yes No

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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? ______________________________________________

I’ve seen: (Circle all that apply) The Matrix Trilogy All 6 Star Wars

Serenity Any season of Red vs. Blue

Are you easily distracted by shiny things? Y N

List your 2 favorite musical genres. _______________________________________________

Favorite sport and team (If any) __________________________________________________

Do you ski / snowboard or would you be willing to learn? Y N

Do you currently have a source of income? Y N

If yes, what is it? ________________________________________________________

Your thoughts on time travel? ____________________________________________________

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 led you to apply for this position?

____________________________________________________________________________

____________________________________________________________________________

Explain why I should pick you as my girlfriend in one sentence.

____________________________________________________________________________

List any special skills you have that may be relevant to this position.

____________________________________________________________________________

____________________________________________________________________________

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Section 6: Relationship Background

Section 7: References

Section 8: Certification

For more information or for help submitting your application, visit http://aredletterday.blogspot.com

List the details of your past three relationships, starting with the most recent.

Name of Boyfriend:

Start Date: End Date:

Were you the: (Circle one) Dumper Dumpee

Reason for breakup:

Name of Boyfriend:

Start Date: End Date:

Were you the: (Circle one) Dumper Dumpee

Reason for breakup:

Name of Boyfriend:

Start Date: End Date:

Were you the: (Circle one) Dumper Dumpee

Reason for breakup:

Please Supply three references and their contact information (Phone, IM, and/or Email).

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

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: __________________________________