Please select if you are a COUPLE or PARENT *
First Name *
Last Name *
Date of Birth *
Partner's Date of Birth
Phone Number *
Please upload a current photo of your and your partner *
Please provide a link to your Facebook
Please provide a link to your Instagram
Please provide a link to your Twitter
Relationship Status *
If engaged, do you have a date or time frame for your wedding?
Do you have any children? If so, how many? *
Where do you currently work? What are your ultimate career goals? *
Tell us a few interesting or unique facts about yourself individually *
How did you meet? *
Tell us about your first dates. What were your impressions of each other? What were your initial attractions to each other?
Describe your relationship. What are the good points and bad points of the relationship? How did you know that this relationship was different from previous relationships?
How do you enjoy spending time together?
Are there any upcoming events (anniversaries, holidays, birthdays, work parties, vacations, etc) that affect your relationship positively or negatively?
What is your favorite story to tell about your relationship?
Describe a couple of romantic moments you’ve shared.
How do you deal with conflict? Do you feel your approach is effective? Why or why not?
What are your friends’ thoughts about your relationship?
What are your family’s thoughts about your relationship?
Describe how these thoughts affect your relationship (positively or negatively).
Are these thoughts keeping you from taking another step in your relationship?
How could experts help bring your family together? What is the main focus of disapproval?
In a perfect world, describe your dream wedding.
How did you hear about the show?
How comfortable are you sharing your story on television? How comfortable will your family be sharing their story on television?
Have you ever been on television before? If yes, when did it air and what was the show?
Please provide names and phone numbers for your 4 closest friends or family members: *We will not contact anyone until we inform you first. Please indicate which of these family members don’t approve of your union. *
Please email us three pictures of you and your significant other to: firstname.lastname@example.org
***Please read the Terms of Service below. By completing and submitting this questionnaire, you are agreeing to these terms***
Producer has no obligation to return any materials submitted by me as part of the participant selection process or in connection with my participation in the Program (the “Materials”) whether or not I am selected as a participant, and I hereby grant Producer the right to, and understand that Producer may, but is in no way obligated to, use any portion of the Materials in and in connection with the Program or any other program(s); and (x) Producer shall have the right to use my Likeness, the Recordings and the Materials in any manner, in whole or in part, in any and all media now known or hereafter devised in perpetuity throughout the universe.