GirlfriendsCafe - Membership Application

Welcome to GirlfriendsCafe

GirlfriendsCafe.com Membership Form

The following information will be utilized to create your Online Listing Profile on GirlfriendsCafe.com. There is no fee to be a member of our organization.

If you have any questions or desire assistance in completing your Membership Form, please send an e-mail to webmaster@girlfriendscafe,com, and we will be pleased to assist you.

GirlfriendsCafe.com's system is designed to protect your personal information. At no time will your e-mail be visible on our site. The items that will be included in your Online Listing Profile and visible to other members are those that are underlined below.

* BOLD FIELDS ARE REQURED


CONTACT INFORMATION
Login Name * This is the nickname that will appear on your profile. Only letters and numbers are accepted. Spaces and other characters can not be used.	Login Name Available! Sorry that login is currently in use.
Password
Confirm Password
First Name *
Last Name *
Email *
Alternate E-Mail If you have a second e-mail address, please enter it in this area.
Address
City *
State/Province *
Zip/Postal Code *
Country *
Telephone

ABOUT YOU

Birth Month *
Birth Day *
Age Range *
Marital Status *
Level of Education
Describe Your Job*
Favorite Quote
What are your Hobbies and Interests *
NOTE: The following area is to be used to introduce yourself to your fellow GirlfriendsCafe members. It is not to be used to promote commercial activities or include links to websites, etc. Applications for membership that include commercial announcements within this section will not approved.
Tell Us About Yourself *
Why are you joining GirlfriendsCafe.com?

DEMOGRAPHIC INFORMATION In order to best serve the needs of the members of GirlfriendsCafe.com, we ask that you complete the following information. GirlfriendsCafe.com does not sell or share this information with any other entity.
Income Range
General Employment Classification
Periodically, GirlfriendsCafe e-mails members regarding news about the site.
Would you like to receive mailings from GirlfriendsCafe.com?	Yes No

HOW DID YOU HEAR ABOUT US?
How Did You Hear About GirlfriendsCafe.com
If you were referred by a current member of GirlfriendsCafe.com, please enter her Login name below:
I was referred by:

Your Online Listing Profile may contain an avatar or a photo. If you wish to add one to your profile, you may do by using the block below. You can add an image at any time via the GirlfriendsCafe.com Membership Area.

To Upload a File for your Online Profile, Press the Browse Button on the form below. It will open a window in your browser, that will allow you to navigate on your hard drive, to where the Photo is located, select it and then press the Open button. The File Name will then appear in the File to Upload box below. When you are Satisfied, Press the UPLOAD button and wait for a response!

The image on your profile must be personal in nature and can not be a company logo, etc.

File:

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