APPLICATION for Membership in SINGLE PARENTS
USA!
Code #: __________________________
(Assigned by Single Parents
USA)
Please print out this form, fill in the requested information and mail
along with your payment to: DOWDYNSON.COM aka
SINGLEPARENTSUSA.COM
3337 WEST FAIRCREST DRIVE, ANAHEIM, CA 92804-3014
Name: ______________________________________________________________________________________________
Address: ______________________________________________________________________________________________
Phone #:
_________________________________ Email Address: _____________________________________________
Write in your
pass word protected profile listing: ___________________________________________________________
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If you wish us to write your profile listing:
(Optional but required if you wish to have access to other
member profiles): Sex __ M __ F Height Ft: __ Inches__ hair color ___eye color: ____
ethnic bg:
_____ religion _____Education:
_____ Occupation _____ Smoker: _ Y _ No Drinking Y _ N _
Interest, Hobbies, Pastimes (What you enjoy):
_____________________ and/or circle the 7 to 10 words
that best describe you: romantic liberal conservative carefree quiet
marriage-minded outgoing
sensitive
intellective affectionate religious considerate open-minded sense of humor
self-confident
exciting
serious trusting athletic loyal optimistic sincere emotional
Type of
person that you would like to meet: _____________________________________________________________ ____________________________________________________________________________________________________
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____________________________________________________________________________________________________
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About your child/children, name(s) hobbies etc: __________________________________________________________
____________________________________________________________________________________________________
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How did you find out about SPUSA? __ Internet ___ Friend
__ Newspaper Other: _____________________________
Note: I authorize SINGLE PARENTS USA to edit and publish the information
contained herein.
SINGLEPARENTSUAS.COM
cannot guarantee the accuracy of any information supplied by its members.
I understand
that giving false information about myself can and may be considered cause for my membership being
terminated
without refund! I will not hold SINGLEPARENTSUSA.COM responsible for any
dealings between myself
and any person(s) that Icontact or who contacts me through SPUSA.
IMPORTANT NOTICE: All applicants must meet qualification requirements! SPUSA reserves the right to deny
membership
to anyone if we believe that to allow membership would not be in the best
interest of SPUSA and/or
it's members. If a member decided to cancel his/her membership before 90 days of full membership SPUSA will
give
that member a FULL refund. However, if a member is canceled by SPUSA for
cause, there will be no
refunds made.
We will do all that we can to protect the privacy and well being of our members!
Sign. of Applicant: ______________________________________________________
Date: ________________________
Categories of Membership (please select
only one, if you are a single parent
and a business owner, your business
advertisement will be FREE!
Option A:
We accept: __ Visa __ M/C __ A/E __ Disc & &
3 digit security # on back of card: __________ _________ ________
Card # ________ /________ / ________ / _________ Exp. date: ________ /________ /_________
Name on Card: ______________________________________________________________________________________
SIGN: __________________________________________________________
Date: _______/_______ /_______
Complete billing address of card:
________________________________________________________________________
_____________________________________________________________________________________________________
PS: Please provide us with your email address:
Email: ______________________________________________________________________________________________
Please print out this
form, fill in the requested information and mail along with the your payment to:
DOWDYNSON.COM aka
SINGLE PARENTSUSA.COM
3337
WEST FAIRCREST DRIVE, ANAHEIM, CA 92804-3014
Welcome Aboard!
DOWDYNSON.COM aka
SINGLEPARENTSUSA.COM
3337 WEST FAIRCREST DR ANAHEIM, CA 92804-3014
VM: 1-800-844-9639 X 4547 ~ Email: gospusa@yahoo.com
PS: Please email your application to us as well
as sending a hard copy in the US mail! If you have questions,
you may use the following form to contact us
at: gospusa@yahoo.com
