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Valentine Application
Please provide answers to be considered for the position.



Area 1:
Please provide positive answers.





Name:


Age:


Height:


Do You Drive:


State You Live In:


Single or Taken:


Would You Date Me:


Kiss On First Date:



Area 2:
What would you do if I...

made a move on you?:


kissed you?:


lived next door to you?:


started smoking?:


asked you on a date?:


was hospitalized?:


ran away from home?:


got into a fight and you weren't there?:


asked you to have sex?:


asked you out?:


told you I love you?:


Area 3:
What do you think about my...


Personality:


Eyes:


Hair:


Height:



Taste in music:







Area 4:
Have you ever....


Lied to make me feel better?:


Wanted to kiss me?:


Wanted to kill me?:


Broke my heart?:


Kept something important from me?:


Area 5:
"X" marks the spot
[ ]Kiss me...
[ ]Hug me...
[ ]Date me...
[ ]Grab my a**...
[ ]Kill me...
[ ]******** me ....
[ ]Love me...
[ ]Hate me...
[ ]Hold me...
[ ]Lie to me...
[ ]Hurt me...
[ ]Sing with me...
[ ]Dance with me...
[ ]Grind with me...
[ ]Cuddle with me...
[ ]Let me make a move on you...
[ ]Make a move on me...
[ ]Watch a movie with me...
[ ]Get me a B-day gift...
[ ]Let me borrow your car...
[ ]Be there for me...
[ ]Buy me a drink...
[ ]Bring me around your friends...
[ ]Give me a massage...
[ ]Drink kool-aid with me...
[ ]Take advantage of me...
[ ]Hangout with me...
[ ]Take care of me if I wasn't feeling good...
[ ]Hold hands with me...
[ ]Do something incredibly sweet for me...
[ ]tell me you love me...