1. FIRST name
 
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2. LAST name
 
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3. Street address? (include apartment if approprate)
 
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4. City
 
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5. State
 
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6. Zip Code
 
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7. What is the primary phone number (include area code) to use for contact and leaving messages?
 
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8. Is this phone number able to receive text messages that can be used to communicate with you? Also, will you be the only person reading your text messages?
 
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9. What is your date of birth?
 
   
10. Height
 
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11. Weight
 
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12. What is your eye color?
 
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13. What is your natural hair color?
 
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14. What is the ethnic origin of country for your mother? (e.g. French, Irish)
 
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15. What is the ethnic origin of country for your father? (e.g. French, Irish)
 
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16. Closest description of your race
 
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If multi-racial, please provide your closest description.
17. What is your blood type?
 
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18. What is your email address for communication with you regarding your pre-screen application?
   
19. What is your preferred password for future login reference?
   (6-20 characters with 4 or more letters and 1 or more numbers)  
20. Verify your password.
   

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