For Men Only  

Step 1 of 2
PERSONAL INFORMATION

In order to be contacted by Janis or Carly, please provide the best contact number to reach you on or you might miss a phone call from us telling you that we have your wife.

MISC INFORMATION

* I certify I am at least 18 years old and acknowledge that all information is actual to the best of my knowledge.

Important Notes/Instructions:

You will be required to pre-process a one-time registration fee of $25.00.
You will only be charged if you are accepted.

All fields are mandatory and must be completed.