APPLICATION FOR PERMISSION TO DATE MY DAUGHTER
NOTE: This application will be incomplete and rejected unless accompanied by a complete financial statement, job history, driving record, lineage, and current certified medical report (including drug tests) from your doctor.
1. NAME _______________________________ DATE OF BIRTH ________________
2. HEIGHT ______________ WEIGHT __________ I.Q _______ G.P.A.____________
3. SOCIAL SECURITY # _____________ DRIVERS LICENSE # __________________
4. BOY SCOUT RANK____________________________________________________
5. HOME ADDRESS _________________ CITY/STATE ___________ ZIP __________
6. Do you have one MALE and one FEMALE
parent?______________________________
If No, EXPLAIN
______________________________________________________
7. Number of years your parents have been married ________________________________
8. Do you own a van? ______ A truck with oversized tires? ______ A waterbed?________ Do you have an earring, nose ring, belly button ring, or a tattoo? ____________________ (If "yes" to any of #8, discontinue application and leave premises)
9. In 50 words or less, what does "LATE" mean to you?____________________________ ___________________________________________________ ___________________
10. In 50 words or less, what does "DON'T TOUCH MY DAUGHTER" mean to you? _______________________________________________________________________ _______________________________________________________________________
11. In 50 words or less, what does "ABSTINENCE" mean to you________________ ___________________________________________________________________________
12. Church you attend _____________ How often do you attend _____________________
13. When would be the best time to interview your father, mother and priest/rabbi/minister? ____
14. Answer by filling in the blank: please answer
freely. ALL answers are confidential (That means I won't tell
anyone -ever- I promise.)
a) If I were shot, the last place on my body I would want wounded
is __________________ b) If I were beaten, the last bone I would
want broken is my ________________________ c) A woman's place is
in the _______________________________________________
d) The one thing I hope this application does not ask me about is
____________________ e) When I first meet a girl, the first thing
I notice about her is _______________________ ( NOTE: If your
answer begins with "T" or "A", discontinue.
Leave premises keeping your head low. Running in a serpentine
fashion is advised.)
15. What do you want to be IF you grow up? ____________________________________
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE
AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH,
DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, ELECTROCUTION,
CHINESE WATER TORTURE, AND RED HOT POKERS.
________________________________________
Signature (That means sign your name)
Thank you for your interest. Please allow four to six years for processing. You will be notified in writing if you are approved. Please do not try to call or write. If you do attempt any communication before your application is approved, automatic disqualification will result. If your application is rejected, you will be notified by two gentlemen wearing white ties and carrying violin cases (You might want to watch your back).
Do you still want to date my daughter?:
_____ Yes, please accept my application
_____ I um, no, I uh, think I have the wrong house...
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E-Mail me at: [email protected]
