Rate This Chick Application

Please fill out all areas, even if it doesn't apply to you. Be honest and be clever, both will help your chances of getting picked. If you've never read Rate This Chick before, we HIGHLY suggest that you do so before submitting an application. Thanks and good luck!

* Name/Heading

* Email Address

* Age

* Body Type

* Height

* Ethnicity

* Smoking

* Drinking

* Do you have kids?

* Occupation

* Religion

* Political Views

* Interests

* Tell Us About Yourself

We require at least one clear picture of you. We prefer shots that at least show more than your face. Pictures should be sent in either JPEG or GIF formats and should not be over 300k in size.

* Attach Your Picture Here

Optional Second Picture

Optional Third Picture

Anything Else You'd Like to Add?

* Do you agree that the information that you provided on this application is a true and accurate representation of you, and that we (The Couch Pirates) have permission to use all text, links and images for the purposes of posting and rating on www.couchpirates.com?

Yes

No

* Indicates Response Required


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