Love FrogKisser

Transforming Your Love Life

Member Interview Form

Please complete this form within 24-hours of the member interview. Questions? Email

Your Name *
Your Name
Date of the Interview *
Date of the Interview
Potential Member's Name *
Potential Member's Name
Please include their first and last name
Please be as descriptive as possible.
Their Preferred Phone Number *
Their Preferred Phone Number
This is the number that will be used to notify them if they have been invited to join.
If they do not want to give you their exact range, you can give them the available age ranges. This is to help us plan events that may appeal to various age groups.
Only individuals that are legally single are permitted to join Love FrogKisser events.
If we have a lot of parents as members, we will look to host some events that parents can bring their children to.
What types of events is this member interested in?
Check all that apply.
Example: Weekdays after 5:00 p.m. and weekends
Examples include: Casual dating, long-term relationship, marriage, friends only
They earn a $25 membership credit on their own account when one of their single friends join. When their friend goes online to claim their 30-day free membership, they need to mention their referring friend by name, so we can credit the account.
We would highlight their first name and photo as one of the featured singles in their city. It would be shared through email and online.