Name* Surname* Age* Email Address* Address City* State Mobile* Landline Upload Picture* Q1. EX-Boyfriend's /Ex- girlfriend's name * Q2. How long were you in a relationship with him / her and why * Q3. 1 common friend between you and your Ex * Q4. How did you break up and why??? Q5. Were you dumped or did u dump your Ex? * Q6. Would you get back with your EX?? Q7. Have you ever lied to your boyfriend / girlfriend / best friend if yes, why Q8. 5 positive points about you Q9. 5 negative points about you Q10. 5 things you don't like about EX-boyfriend / EX-girlfriend * Q11. List your interests and hobbies Q12. How well do you know your ex-boyfriend / ex-girlfriend?? * Q13. Have you been on a reality show before if no, why Q14. Are u currently single Q15. Where is the ex boyfriend/ex girlfriend located now * Q16. Was there any 3rd person involved in your break-up and who??? * Q17. Was it an ugly or a mutual break up * Q18. Please list your special talents that set you apart from others auditioning Q19. Do you suffer from any physical / cardio vascular ailments? If yes, please elaborate Q20. Tell us about yourself in 1 sentence Q21. 5 things you would do to make your ex-boyfriend/ex-girlfriend suffer/ feel humiliated??? * Q22. Name and number of 2 Common friends [All Fields marked * are mandatory]