| Country Music Singles Membership Form |
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| Important Information |
| | | | Type of Relationship Desired: | | |
| | | | | Are You Willing To Relocate: | | |
| | Location: | Williams Lake, British Columbia
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| Physical Characteristics |
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| General Information |
| | | | | | | How Country Are You: | | | Drive a pickup truck, Farming, Horseback Riding, Love Country Dancing, Love the smell of fresh cut alfalfa, Rodeos, Wear the hat, Wear Wranglers
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| Tell About Your Family |
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| Design Your own Country Profile |
| Describe Your Personality | | |
| | | | What Are You Looking For: | | |
| | | Are You a Single Who Is.. | | |
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| Country Music Section |
| Who Are Your Favorite Country Music Artists? | | |
| | A dream date for you would be with what Country Artist? | | |
| | What type of Country Music Do You Like: | | |
| | What was your favorite live concert: | | |
| | Who would you like to see in concert: | | |
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