Asian Ladies Asian Women

LADIES! Sign up here to be published in our quarterly catalog and web site! WWW.PACISL.COM

Name:		Phone Land Line:
*Email address:		Cell:

POSTAL Mailing Address: (note) We cannot publish you if you don't include your MAILING ADDRESS!

(must be good for at least 6 months) (Must include POSTAL CODE) PLEASE type or print carefully.

Birth Date:		Height:
Weight:		Religion:
Civil Status:		Body Measurement:
Occupation:		Kids
Citizenship:

Qualities: and FB page:

Hobbies:

Ideal Man: (age, race, etc)

Do you accept divorced man? Yes No

Do you accept man who smokes or drinks? Yes No

Do you want your photo to be published in our next magazine? Yes No

(if yes, please email us your best smiling color photo with a light background)
A swimsuit photo will get the most responses! Photo must be clear and in focus. info@pacisl.com

Have you been a member of our club before? Yes No When?

Where did you hear about our club?

← please leave this empty to show you are human

What is your FACEBOOK page?

Please email us your photo at info@pacisl.com

Please tell all your friends about our website! We always need more ladies! Note: DO NOT ASK our clients to send you any money! If you do, we will NOT publish you! And you will be BLACKLISTED!

LADIES! Please COPY or SAVE this page after you fill it out, then EMAIL it back to us as an ATTACHMENT!

or send us a SCREEN SHOT of the application!

THANKS!

The staff at USA CONNECTION

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