|
| Name:
|
 |
|
| Title:
|
 |
Miss |
|
Other |
|
Date
of Birth: |
 |
|
| |
| Relatives of
note: |
|
McCartneys |
|
Palmer-Tomkinsons |
|
Windsors
(Barbara or Elizabeth) |
|
|
Other,
please specify: |
|
|
| Please
advise us of any long-lost relatives
with whom we could re-unite you |
| (long-lost
= 18 months minimum): |
|
|
| |
| Information
on partner: |
|
Uruguayan
supermodel |
|
flatmate
of British pop singer |
|
irascible
tennis star |
|
|
Other,
please specify: |
|
|
| |
| Your
perception of your celebrity status: |
|
A |
|
B |
|
C |
|
D |
|
| Media
perception of your celebrity status: |
|
A |
|
B |
|
C |
|
D |
|
| |
| Please
describe briefly a side of you that
is "rarely seen" which we
can exclusively reveal: |
|
|
|
| |
Please
complete the following sentence:
I feel that I was put on this planet
to : |
|
|
|
| |
