Form 1-A

Application for
One (1) Date

Submitted in triplicate. One copy for you, one copy for me, one copy lost immediately.

1 Compliance with stated requirements

Your published terms. Reviewed in good faith.

2 Preferred venue

Select one. All options have been pre-vetted for exit routes.

3 Preferred window

Select one. Counter-offers welcome and, honestly, expected.

4 Conditions

Select as many as you like. These are binding. Legally, no. Morally, yes.

5 Signature

Sign here — first name is plenty

Processing time: however long it takes me to check my email. Which is immediately. This form reports to exactly one person and no one else.

Application forOne (1) Date