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ALL ANSWERS ARE REQUIRED or
Enter N/A for those that do not apply to you |
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Your First Name |
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Your Last Name
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Add
Jr, Sr, I, II, III if any apply
Note: Your real name is required.
No exceptions! |
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10 Digit Cell Phone#
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Make sure # is correct!
Please
Use this format: 000-000-0000. |
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10 Digit Alternate Phone # |
or N/A: Make sure # is correct!
A Back up # in case we cannot reach you on cell |
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Email Address |
Required |
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Alternate Email Address
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If you are an AOL user, please provide an alternate
email address (hotmail, yahoo, etc) as we have
trouble getting emails through to our members
who use AOL. Hotmail & Yahoo are free to use.
WE DO NOT SPAM!! WE DO NOT SHARE YOUR INFO!
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What password would you like to use
for your login? |
Use mix of 10-12 numbers &
letters. No Capped letters or other characters like
, "# $ : ; % ^ *_ or -. |
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Confirm Password: |
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Your Gender: |
Male
Female |
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Nick Name or Handle |
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Your State or Province |
Service is offered to US & Canada
residents Only |
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Your
Job Status: |
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Your Date of Birth |
Required |
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Select One: REQUIRED |
If you are married, not waiting for
divorce, you are not eligible for membership, even
if you're looking for just friends.
I
am Single & Never Been Married
I
am Divorced Single
I am a
Single Widower
Single
Widow
I
am Separated, Waiting for Divorce |
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I am In Search Of a |
Male
Female
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Select One: REQUIRED |
Your Orientation Status:
Straight
Gay
Lesbian
Bi-Sexual
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Are you a smoker? |
Yes
No |
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My Truck is my Home:
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Yes
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Physical Address [Home]
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P O Box, St, Rd, Av, Cv, Ct or
N/A |
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Your City of Residence
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Or where you take time off |
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Zip Code |
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If different than home address please give us your |
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Mailing Address
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Or
Same as Home
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City/State/Zip |
Or Same
as Home |
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How often are you online?
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Daily
1
- 2 times per week
1
- 2 times per month
Hardly
Ever
Other:
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Do you have a computer with you on the road? |
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Yes
No
I
surf the web on my cell phone
I
have a PC at home
I
am at home on my PC daily
(Note: Many cell phone
internet connections cannot
access or allow you to fill out secured forms) |
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I am seeking age from:
to
Be realistic in your age
preference. Too young to too old for you will not be
received well by possible interested members. The
search is set up to find your age group
according to your Birth Date, not the age range
preference you are seeking.
How did you hear about TruckerCupid?
Search Engine
Sirius Radio
XM Radio
CB
Radio
Another Web Site
Vegas
Truck Show
Word
of Mouth
Louisville Truck Show
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Do you want to be able to send private messages to
members of your interest? |
Yes
No
Not
Right Now (Winks are Free)
To send a private message
there is a small fee of $20 for 30 days. We DO NOT
auto renew when your Premium membership expires. You
will receive a phone call notification of expiration. |
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Do you have a head/shoulders Photo of yourself to
Post? |
Yes
No
Will
get one in next few days
I
have a good photo but need help posting it |
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If have a head/shoulders
photo and cannot or do not know how to post it, email it to the address at the end of this
page as soon as you submit this request form. Make
CERTAIN you type your ENTIRE NAME into the subject line
w/ the word Photo. The photo must be a .JPG.
Photos too small of you will not be posted in image
scroll bars. If the photo is larger than 200x200 it
will post all blacked out so make sure it is not too
large. |
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Upload your head/shoulders .jpg image file below.
It must not be larger than 200x200 pixels in size or
too small.
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This section will be posted on your Profile and you can edit
it anytime once your membership has been approved.
We are notified when a profile has been edited. |
REQUIRED: Describe yourself & the kind of person you'd
like to meet for a personal relationship or to team
together.
Up to 2000 characters allowed. Foul language &
sexually explicit comments not allowed. Email & web
site addresses, phone numbers and physical addresses
not allowed as this section will be posted on
your public profile!
You MUST add the following email address to your
email's address book to receive contacts from Member
Services:
WE DO NOT SPAM!! WE DO NOT SHARE YOUR INFO!
membersupport[at]truckercupid.com. Replace [at] with @.
Allow
24 to 48 hours for Phone Response HOWEVER Most Approval Calls Are Made
the Same Day
of your Request.
We do not approve memberships on Sat. night or
anytime on Sundays. |