APPLICATION FOR PERMISSION TO DATE MY DAUGHTER
NOTE: This application will be incomplete and rejected unless
accompanied by a complete financial statement, job history, lineage, and
current medical report from your doctor.
NAME_____________________________________ DATE OF BIRTH_____________
HEIGHT___________ WEIGHT____________ IQ__________ GPA_____________
SOCIAL SECURITY #_________________ DRIVERS LICENSE #________________
BOY SCOUT RANK AND BADGES__________________________________________
HOME ADDRESS_______________________ CITY/STATE___________ ZIP______
Do you have parents? ___Yes ___No
Is one male and the other female? ___Yes ___No
If No, explain:
_____________________________________________________________
_____________________________________________________________________
Number of years they have been married ______________________________
If less than your age, explain
________________________________________________________________
____________________________________________________________________
ACCESSORIES SECTION:
A. Do you own or have access to a van? __Yes __No
B. A truck with oversized tires? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
F. Do you have an earring, nose ring, __Yes __No
pierced tongue, pierced cheek or a belly button ring?
(IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION
AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
ESSAY SECTION:
In 50 words or less, what does 'LATE' mean to you?
__________________________ ____________________________________
______________________________________________________________
In 50 words or less, what does 'DON'T TOUCH MY DAUGHTER' mean to you?
______________________________________________________________
______________________________________________________________
In 50 words or less, what does 'ABSTINENCE' mean to you?
______________________________________________________________
______________________________________________________________
REFERENCES SECTION:
Church you attend ___________________________________________________
How often you attend ________________________________ ________________
When would be the best time to interview your:
father? _____________
mother? _____________
pastor? _____________
SHORT-ANSWER SECTION:
Answer by filling in the blank. Please answer freely, all answers
are confidential.
A: If I were shot, the last place I would want shot would be:
______________________________________________________________
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. What do you want to do IF you grow up? ___________________________
______________________________________________________________
______________________________________________________________
F. When I meet a girl, the thing I always notice about her first is:
______________________________________________________________
F. What is the current going rate of a hotel room? __________________
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, CRUCIFIXION, ELECTROCUTION, CHINESE
WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_________________________________________________________
Applicant's Signature (that means sign your name, moron!)
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