4
 

Waiting List for Sunday 13th Nov2011
20s and 30s at the Hub Cork.
Please note: We very often publish some of your profile details on our website for upcoming events. Because of the very sensitive nature of this business and to maintain your anonymity we would prefer if you gave us a nickname. This will be used instead of your first name if we publish your profile.
We only publish the following: - Nickname, Age, Profession, Interests/something interesting about you and the County you reside in.

Personal Details

 
Waiting List
Nick Name

Not too long please Your nickname will be used instead of your 1st name if we publish your profile before upcoming events.
Date of Birth

First name:
Surname:
Gender:
 Please make a selection. Male   Female
Age:
 Your age might be shown if we publish your profile on our website before upcoming events.
Email:
Telephone #1:
 Numbers only (Mobile)
Telephone #2:
 Numbers only (Landline) Optional
Profession:

Your profession might be shown if we publish your profile on our website before upcoming events.
Hobbies/interests. Likes/Dislikes and/or something different or interesting about yourself.

This might also be shown if we publish your profile on our website before upcoming events.
Please type in the names of the other applicants in your group. It helps to eliminate confusion.
Where did you hear about us?
What county do you live in?
If you have any particular reservations or instructions about what should or should not be published please let us know in the box provided on the right. We will be happy to oblige.

If you are you finished with the above applicant please hit the Submit button below (or Reset to clear your details & start again)