Fantasy Island - Reality TV

Please fill in the required fields to submit your application form

Compulsory - $ US 25,000.00 - Unique advertising opportunity

Christian Name:
Middle Name:
Surname:
DOB:     Age:  
Address  
in Full:
State:     Zip Code:  
Country:
Nationality:
Religion:
No Languages Spoken:
Occupation / Business:

Phone Details. Please provide area codes for all numbers.
Home:
Work:
Cell / Mobile:

Do you drink?
Do you smoke?
Height:     Weight:  
Clothing Size:     Build:  
Complexion:
Hair Colour:     Eye Colour:  
Email:
Referred By:

Questions to be Answered
Are you afraid of commitment ?
Are you the Chaser or the Chased ?
Did you have a Happy Childhood ?
Are you Adventurous in Bed ?
Are you Selfish in Bed ?
What would make you end a relationship ?



You are also required to email us at fantasy@realitytvaust.com (1) one recent photo being a full length shot. The photo is to be of a small postcard size and to be sent separately to your bachelor application.
Be sure to mention your first and last name in the email.