Wufoo

Be a Single

Note: All UnMe singles that are accepted are charged a $149 fee!

If you meet all of the requirements and think you'd be a good fit, fill this form out. We're waiting for you!

This form REQUIRES at least 15 minutes of your time.

The Basics

Tell us a little about yourself.
Name * First Last
Date of Birth * MM / DD / YYYY
Phone * ### - ### - ####
Email *
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Employment

We want some info on where you work!
Employer
Employment Status *
Occupation *
What is one thing you like about your job?
Love

Tell us about your ideal mate, we'd love to hear about it.
Do you enjoy being alone? *
Would you be willing to relocate for the right person?
Describe your ideal mate *
When it comes to romance, what's your perfect evening? *
What is your opinion or thoughts on finding a soul mate?
Do you think it is ok for someone you date to have really close friends of the opposite sex?
Miscellaneous

Everything else in between.
Do you still have that bad habit your mom nagged you about? *
Have you appeared in any magazines, publicly disseminated photographs, advertisements or the Internet? *
How close were you/are you with your parents and/or brothers or sisters? *
How likely are you to do some hands on volunteer work?
Are you happy with the choices you have made in life?
Do you have any hobbies? *
Outdoors Sports Art Collecting Travel Reading Other
Why do you think you would be a good fit for this publication? *
Name one thing you are proud of. Why? *
Name one thing you are not proud of. Why? *
What would you do with $500,000? *
What’s your funniest childhood memory?
Pictures

What do you look like? I know! how superficial right?
Required Photo *
Additional Photo
Additional Photo
Legal Mumbo Jumbo

No bank thiefs or drug lords allowed! After this you're done!
Have you ever had a restraining order of any sort filed against you? *
No Yes
Is there any pending litigation against you? *
No Yes
Have you ever been evicted? *
No Yes
Have you ever been the subject of disciplinary proceedings or actions in school, in the military, at work or in any other context? *
No Yes
I agree that anything I disclose can be used in the publication *
Yes
I agree to all terms and conditions *
Yes
I understand there is a $149 fee if I am chosen as a UnMe single *
Yes
Do Not Fill This Out

Wufoo

Be a Single

The Basics

Employment

Love

Miscellaneous

Pictures

Legal Mumbo Jumbo