NAME______________ DATE_________
AGE________ SEX_______
ADDRESS__________________________________
CITY___________________STATE_______
IF LESS THAN 5 YEARS NEXT PREVIOUS ADDRESS_________________________________________
PHONE___________________
EMAIL___________________
EMPLOYMENT HISTORY___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2ND MOST RECENT EMPLOYER________________________________________________________________________________________________________________________________________________________________________________________________
MAY WE CONTACT__________
REFERENCES____________________________________________________________________________________________________________________________________________
HAVE YOU EVER OR ARE YOU NOW BEING TREATED FOR ANY TYPE OF MENTAL ILLNESS_________________________________________________________________________________________________________________________________________________________________________________________________
MEDICATIONS TAKEN_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HOW OFTEN_________________________________________________________________________________________________________________________________________________
HAVE YOU EVER BEEN CONVICTED OF A FELONY______________ IF YES EXPLAIN_______________________________________________________________________________________________________________________________________________

ANYTHING ELSE YOU MAY WANT TO BE CONSIDERED, THAT MAKES YOU A GOOD CANDIDATE_______________________________________________________________________________________________________________________________________________________________________________________________

Weight in most recent picture?_______________________
Weight as of this very minute?_______________________

NAME: newg78 DATE: 03 May 2008
AGE: doesnt matter SEX: M-W-F
ADDRESS: http://www.justsayhi.com/newg78
CITY: of angels STATE: of shock
IF LESS THAN 5 YEARS NEXT PREVIOUS ADDRESS: N/A
PHONE: 1800-1888-IDOL-502
EMAIL: newg78@justsayhi.com
EMPLOYMENT HISTORY: secret
2ND MOST RECENT EMPLOYER: myeslf
MAY WE CONTACT: my dog Buttons
REFERENCES: Mike & Van
HAVE YOU EVER OR ARE YOU NOW BEING TREATED FOR ANY TYPE OF MENTAL ILLNESS: FYI, I am mentally capacitated
MEDICATIONS TAKEN: pretticillin (Anti-Prettiness)
HOW OFTEN: every 4 hours daily
HAVE YOU EVER BEEN CONVICTED OF A FELONY: No.
IF YES EXPLAIN: N/A

ANYTHING ELSE YOU MAY WANT TO BE CONSIDERED, THAT MAKES YOU A GOOD CANDIDATE: I am online 25/8

Enough

BOW!