Affinity for Love Workship

I Know What Girls Like - I Know What Boys Want:
Dating & Embracing Love During a Pandemic
Panel Application & Questionnaire
To apply to be a panel member for this event, please complete all questions.
Name*
First NameLast Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
E-mail*
Home Number
Area CodePhone Number
Cellular Number*
Area CodePhone Number
Work Number
Area CodePhone Number
Social Media*
https://www.facebook.com/mysocialmediais
Social Media*
https://www.instagram.com/mysocialmediais
Social Media*
https://www.twitter.com/mysocialmediais
Social Media
https://www.snapchat.com/mysocialmediais
Social Media
https://www.tumblr.com/mysocialmediais
What is your relationship status?*
Are you willing to openly discuss elements of relationships that will be asked by a panel of dating, relationship and other coaches?*
Questions to be asked are not to be incriminating.
Are you willing to purchase a shirt for this event? *
Details on ordering will be emailed to you.
Are you willing to be open and honest about your life and past relationship challenges?*
The goal is to assist others in knowing that there is hope.
What is you highest level of education?*
Tell us about your educational background.
List your educational institutions.*
Discuss your current career, career goals, and plans for any future careers.*
What are your beliefs about relationships?*
This is a no judgment zone. We want to hear from you and learn your perspective on relationships.
What is your desired type of relationship?*
If you could have it your way, what would you have in your relationship?
Sexual Orientation*
Who were you born as?
Do you ever want to get married?*
Do you have any children?*
Do you want children?*
Do you consent to having your information shared amongst the coaches who will participate on the panel?*
Your information is private and will never be sold or given away for any reason.
What was your life like as a child?*
We want to hear and learn about your past as a child and adolescent. Please be as detailed as possible.
What are your hobbies?*
What do you like to do in your spare time?
What do you do for Self-love & Self-care?*
Do you have anything additional to add?
Please upload a photograph of yourself. Must be a professional type photo (we will accept selfies), but it has to have a clean background and no additional people in the picture.
This is required. If you submit this form without a photo of yourself, you will not be selected.
By submitting this form, you are giving Thr Ruth Factor and its subsidiaries permission to use it for the purposes of this event and anything pertaining to this event, incliding marketing and advertising.
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Panel Application & Questionnaire