Name: __________________________ (nee ________________________ )

I would like to be a contestant on Real Housewives of ____________ (Major Metropolitan Area).

Section 1: I am batshit crazy in this specific way (please circle one):

A.  I enjoy throwing charity events that do not really make any money for charity.

B.  I like to throw fashion shows but I don’t believe having actual clothes to show is important.

Section 2: If chosen, I promise I can get plastic surgery on my (please check all that apply) :

___ 1. Breasts

___ 2. Nose

___ 3. Brow Line

___ 4. Fingers

___ 5. A place I will only show on national television.

Section 3: I promise, as a participant, I am willing to alternately shop and catfight.  I also promise to ignore that this entire show is just a reality tv version of Desperate Housewives.  I understand that if the name Bree is mentioned, this application is null and void.

Signature: ______________________

Date: _________________