APPLICATION TO DATE MY_DAUGHTER

1. Name ______________________ D.O.B. _______________

2. Height _______ Weight_______ I.Q. _______ G.P.A. _______

3. Social Security # ________________ D.L. # ________________

4. Boy Scout Rank ___________________

5. Home Address ______________________ City ________ St. _____

6. Do you have one Male and one Female Parent ___________

If no, explain _________________________________________________

7. Number of years parents married __________

8. Do you own a van? _______ A truck with oversized tires? _______ A waterbed? _______ An earring, nose ring, or bellybutton ring? _______ A pierced tongue? _______ Or any other anatomical part _______
(If yes to any of #8, DISCONTINUE APPLICATION AND LEAVE PREMISES)

9. In 50 works 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 and how often? ___________________________________

13. What would be the best time to interview your mother, father and minister? _________________________________________________________________

14. Answer by filling in the blanks. Please answer freely. All answers are confidential (that means I won’t tell anybody, ever, Promise)

A: If I were to get shot, the last place on my body I would want to be wounded is _____________

B: If I were to be beaten, the last bone I would want broken is my ____________

C: A women’s place is in the ______________

D: The one thing I hope this application does not ask about is _______________

15. What do you to be IF you grow up? _____________________

I BELIEVE THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN TORTURE TREATMENT, ELECTROCUTION, RED HOT POKERS AND THE HILARY CLINTON KISS TORTURE.

__________________________________
Signature (that mean’s your name,goof)

Thank you for your time. Please allow six years for processing. You will be notified in writing if you are approved. Please do not try to call or write (since you probably can’t and it will cause you injury.) If your application is rejected, you will be notified by two gentlemen wearing white ties and carting violin cases (you might want to watch your back.)