Consultant / Host Application Form for Your Choice Dating.com:

First Name:
Last Name:
Address:
City:
State/Province:	/
ZIP/Postal Code:
Country:

Date of Birth - Optional:	//
Are you at least 21 years of age? Yes / No

Contact Information

Phone Number:

E-mail:

How did you hear about this position?

Are you legally eligible to work in the country in the you intend to organize events?
Yes No

Are you available to work a minimum of 10 hours per week outside your current position, on an on-going basis, to promote, organize, and host your events?
Yes No

Please provide an example of an event or activity you planned, organized and hosted. (Hint � are you are organized, detail oriented and reliable?)

At Your Choice Dating events, the host is responsible for setting a fun and comfortable atmosphere for speed daters. Tell us why we can count on you to take charge of a room full of people and make sure they have a great time.

Do you own a computer?	Yes No
Do you have a color printer?	Yes No
Do you have access to the Internet?	Yes No
Can you check your email regularly?	Yes No

Have you ever been convicted of a crime? Yes No
If yes, please provide details.

If accepted, are you aware of the required $99 fee and start- up costs?
Yes / No
(If you select 'No', your application will be denied. Please click on the above links -which will open in new windows- to become aware of the costs and then select 'Yes')

Thank you for taking the time to complete the application. Please ensure your information is correct, (especially your email address & phone no.) then, if you agree, click on the button below.