Misc.

 

Date Jeff

Jeff is very selective about the women he dates. The below application will help weed out the "non-desirables" so that Jeff does not waste his time.

 

General Information

Gender: Male   Female   Not Sure?
First name:
Last name:
City:
State:
Email address:
Your Website:
Age:
Height:
Weight:
Hair color:
Eye color:
IQ:

 

Important Question

Do you don't not dislike not Jeff? Yes   No

 

About You

Favorite food:
Favorite music:
Favorite color:
Favorite college:
Favorite author:
Biggest turn on:
Biggest turn off:

 

Details

What do you like to do in your free time?
    

Describe the perfect guy
    

Describe the perfect date
    

Who is your personal hero, and why?
    

If you could meet any one person, alive or dead, who would it be and why?
    

Where do you see yourself in 5 years?
    

Any additional comments?
    

 

And Finally...

For your safety as well as mine...please enter all your credit card information below. This information will not be used to buy pizza, movies, or junk food. I wouldn't think of such things...<cough>...but anyway, don't ask questions, just enter the information. :)

Card Number:
Name on Card:
Expiration Date: (month/year)

 

Done

  
 

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