Listing A Member *Application*

Picture ??                                      Location:

Name:                                          Age:

Height:                                         Weight:

Hair:                                            Eyes:

Marital Status:                               Preference:

Religion:                                        Education:

Nationality:                                   Race:

Occupation:                                    Children:

Home Town:                                   Relocate:

Release Date:                                Smoke:

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Name:                                          Title or Heading:

Write Me At:

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 If there is any information that you are asked above that you do not wish to have listed on the website please let us know:

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Please tell us with about 150 words or less, about your interest, any hobbies, enjoyable activities, plans for the future, or the type of things you would find interesting in other people. Write on other side if more room is needed

THIS IS WHAT YOUR AD WILL SAY ABOUT YOU (MUST BE CLEAN AND ABLE TO PUBLISH)

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Print this application and mail it to the member you wish listed.  Then have them mail it back to us at our address.