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Please use this text, if you are having problems with the form. Simply copy this text to your e-mail, and fill in the blanks...
*
Required Information
Yahoo! ID
*
:
Provide your Yahoo ID
Name
:
Enter first name only, or full name if you wish
e-mail
*
:
Provide e-mail address for us to contact you
Publish my e-mail
: Yes/No
Date of birth:
Month/Year
This information will be used by the editor to update your age each year.
Disability
*
:
Describe your disability
Publish my disability
: Yes/No
Location
*
:
Where in the world are you? US resident, please specify state.
Age
*
:
How old are you?
Sex
*
: M/F
Looking for
*
: M/F
Smoke
: Yes/No
Drink
: Yes/No/Socially-Occasionally
Occupation
:
Photo
:
Send with e-mail, or include URL for pic online
Hobbies
:
Other Info
:
Looking for
:
*
PenPal (Someone just to chat with)
Dating (Make friends and Have fun)
Romance (Looking for the Love of my Life)
Intimate (Seek sexual encounters)
Delete what you're
not
looking for.
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