Two lucky people will be selected to participate in a real blind date... So real that they will wear blind folds during the date.

Are you looking for someone special? Someone that is interested in more than just your looks?

Enter your information below. We will select two people to come in during the morning show and take dating to a whole new level! If you both decide to go on another date, we will provide both dinner, and a movie!

Birth Date:
Full Name:
Street Address:
City:
State:
Zip Code:
Day Phone:
Evening Phone:
E-Mail Address:
Please Provide a Picture:	(Max File Size 3MB)
Tell us a little about yourself:
You are interested in:
Describe your perfect mate:
Comments:

If you have any issues, please make sure your photo is less than 3mb in size. For other issues, please contact us.