Lucky in Love (A Reality TV Romance)

Three (the nomination)

LUCKY IN LOVE

NOMINATION

I am nominating a:         |  | Lucky Lad       |X| Lucky Lady

Nominee's Name: Alexandra Strickland

Nominee's City and State of Residence: Portland, OR

Nominee's Contact Information:
Cell # [REDACTED]             Home #  N/A      
Email:  [REDACTED] 

Age:  25              Birthdate:   3/18/94               

Height: 5'6"         Weight: 125lbs          

Eye Color:  Brown         Hair Color:  Blue (Brown)

Ethnicity:    |X| White    |  | Black or African American     |  | Hispanic or Latino
    | X | American Indian or Alaskan Native      |  | Native Hawaiian or Pacific Islander
    |  | Middle Eastern or North African     |  | East Asian     |  |  South Asian
    |  | Other Asian     |  | Other                                |X| Two or more

Religion (optional):  agnostic, I think?       

Does the Nominee know you are nominating him/her for "Lucky in Love"?
    |  | Yes        |X| No

Nominee's occupation:  bartender & bike courier

What is his/her highest level of education?  Bachelor's degree

Does the Nominee have any children?        |  | Yes        |X| No

Tell us about the person you are nominating: Alex has been UNlucky in love as long as I've known her. Despite dating both men and women, and being fully willing to throw her whole heart into every relationship she has, with a joy and delight for life, she has never maintained a long term relationship that didn't end in heartbreak or worse. As her friend, I know she's picking the wrong people because somehow she doesn't think she deserves a stand-up partner. She is outgoing and funny and the life of the party, but is also incredibly smart both intellectually and emotionally, yet she's dealt with deadbeats, obsessive exes, and completely immature partners. She deserves so much better, but honestly I think she still blames herself for her brother's death and won't allow herself to go after real promising partners because she doesn't think she deserves to be happy. But she does! And she has so much love to give.

Is the Nominee a legal U.S. resident?        |X| Yes        |  | No

What is your relationship to the Nominee (optional)? Friends since high school; my fiance is her best friend since childhood

Your Name (optional): Nona Park

Your Contact Information (optional):
Phone # [REDACTED]
Email: [REDACTED]

How did you hear about our search:     |  | Radio    |X| Television        |  | Magazine  
    |  | Other, explain                                                                  

I acknowledge that all the information provided on this questionnaire is true and accurate, and any false or misleading information submitted herein is grounds for the immediate elimination of my Nominee from consideration. I further understand that by submitting this questionnaire, the Producer has no obligation to me, and may use all information (including my personal information) as provided herein as the Producer in its sole discretion sees fit with respect to the Program and/or the selection process. This questionnaire and any other material submitted by me, including, but not limited to, pictures, film and videotapes, becomes the property of EMN United, Inc., and shall not be returned and may be used in any manner in all media, worldwide, in perpetuity. I further understand that by submitting this questionnaire, Producer has no obligation to accept my Nominee and the selection and participation of my Nominee in "Lucky in Love" is in no way guaranteed, as it is merely for the purpose of evaluating potential participants. I agree to indemnify and hold Producer harmless from and against any and all claims, losses, liabilities, damages and expenses, including reasonable attorneys' fees, which may result from any breach of the representations and warranties herein.

Signature: -------------------   Date: ----------

You must include one or more recent pictures of the nominee (photos will not be returned). We do not accept nominations without a picture.