Contact Details
First Name *
Last Name *
Do you have a nickname and where does it come from?
Email *
City *
State *
Cell Number *
Work Number
Home Phone Number
Personal Info
Age (DOB) *
Height *
Weight *
Hair Color
Eye Color
Do you have a valid U.S. Passport? *
How did you hear about our search? *
Have you ever applied for the show before? If so, when? *
Are you currently... *
Occupation
Annual Salary
What is your highest level of education? *
What did you study and which degree(s) did you earn?
School(s) Attended
Are you a legal resident of the United States? *
If no, where are you a legal resident?
Where were you born? *
Where did you grow up? *
Do you have siblings? If yes, how old are they? *
Have you ever been arrested, charged or convicted of a crime of any type? If so, please give details and dates: *
Have you ever had a temporary restraining order issued against someone or had one issued against you? If so, please give details and dates: *
Have you ever filed for bankruptcy or chapter 11? If yes, please explain. *
Have you ever auditioned for or been a performer, participant or contestant on a reality or other TV or radio show or in a film? *
If yes, please explain and give dates
Do you drink alcoholic beverages? *
What's your favorite drink?
Have you ever been married or engaged? *
If yes, how many times? Please list wedding date(s)
If you have been married, why are you no longer together?
List the date when such marriage(s) were legally dissolved
Do you have any children? *
If yes, please list their names & ages and if they live with you or not.
Are you genuinely looking to get married and why? *
Why would you want to find your spouse on our TV show? *
Please describe your ideal mate in terms of physical attraction and in terms of personality attraction. What is most important, physical attraction or personality when first meeting someone? *
How many serious relationships have you been in and how long were they? *
What happened to end those relationships?
Have you ever participated in online or social media dating? *
Please list your social media profiles usernames: *
What are your hobbies and interests? *
Do you have any pets? *
Do you have any special talents? Tell us! *
Do you speak any languages besides English? *
List 3 adjectives that would surprise people about you: *
Do you have any tattoos? If yes, what are they? And where are they located on your body? *
Do you have a bucket list? If so, what’s on it? *
What accomplishment are you most proud of? *
What have you not found but would like to have in a relationship? *
Why would girls think you are an eligible Bachelor? *
Photo of Yourself *
Additional Photo of Yourself *
Additional Photo
Privacy Policy *
Terms of Use *
Eligibility Requirements *
Signature *
