NAME
LAST

NATIONAL CUDDLE BUDDY ASSOCIATION
Official Cuddle Buddy Application

FIRST 	MIDDLE INITIAL

        D.O.B. 	HEIGHT	WEIGHT 	PHONE NUMBER

M 	D 	Y
/	/

Male
Female

FEET

INCHES
/

LB.s

ADDRESS 	EMAIL ADDRESS

STREET 	

CITY 	 STATE/ZIP 	

RATE THE IMPORTANCE
OF   THE   FOLLOWING,  AS  THEY   RELATE   TO
CUDDLING, LISTING THEIR IMPORTANCE IN

ACCEPTED PET-/NICK- NAMES

CUDDLE OUTFIT (preferred)

N/A

N/A

ORDER OF MOST IMPORTANT (1) TO LEAST IMPORTANT (4) USING THE NUMBERS 1, 2, 3, AND 4, USING EACH NUMBER ONLY  ONCE.
Hand-holding Warmth Closeness Comfort

RATE YOUR CUDDLING
USING   THE    SCALE    PROVIDED,   MARKING
ONLY ONE BOX.

1 WORST	BEST 10
CUDDLE POSITION  (preferred) DESCRIBE YOUR  FAVORITE CUDDLING POSITION IN  A FEW SENTENCES.

I hereby acknowledge that all information provided is accurate to the best of my knowledge and may be used in any official manner regarding this NCBA OFFICIAL CUDDLE BUDDY APPLICATION (Form R1A), hereby acknowledging  that it will only be used in such a man- ner and will not be shared or released to a third party. I furthermore agree that I may be contacted through any means using any of the methods I have provided in this application, and will be notified upon Acceptance or Rejection, upon which further communication

OFFICIAL USE ONLY (leave blank)

DATE

can and will begin.

SUBMITTED

/	/
M 	D 	Y

SIGNATURE  	

ACCEPTED 	REJECTED