Rebecca's
Official Boyfriend Application Form

16918

Personal Information First name: Last name:

Age: Height:

Are you geographically desirable? (were do you live monkey boy)
Adress:

City: State: Phone:

Do you have an on-again, off-again girlfriend? Yes: No:

Are you registered to vote? Yes: No: Party affiliation:

Have you ever been in therapy? (If yes please explain, If no please explain)

Are you an employee of Philip Morris?
Yes: No:
(If so, do not complete this form)

Blow job: impeachable offense?
Yes: No:

Lying about it impeachable offense?
Yes: No:

Kids? Can't live with'em? Can't live without'em
(Be brave monkey boy check one)

Are you serious about dating me?
Yes: Or did you fill this out just to be cute?

Please write a short essay

Email me your picture
(extra points for creativity)

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