APPLICATION FOR PERMISSION TO DATE MY DAUGHTER

Name:_________________

Date of Birth:_______ Height:_______ Weight:_______ I.Q.____GPA:_____

Social Security Number:________Driver's License #:________ Boy Scout Rank:______

Home Address:__________ City:________ State:____ Zip Code:_____

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How far can you run: 40 yards?____________2 miles?______________

Do you own a? A)Van____ B)Truck with oversized tires?_____ C)Waterbed?_____

Do you have an earring, nose ring or belly button ring?__________ Tattoo?_________

NOTE: If you answered YES to any part of questions #8, discontinue the application process and leave the premises!

In 50 words or less, what does "LATE" mean to you?
_________________________________________________________________
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In 50 words or less, what does "DON'T TOUCH MY DAUGHTER" mean to you?

_________________________________________________________________
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In 50 words or less, what does "ABSTINENCE" mean to you?
_________________________________________________________________
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Church you Attend:_______________How often do you attend? ______________

When would be the best time to interview your father, mother and minister?______

Answer by filling in the blanks. Please answer freely. All answers are confidential. (That means I won't tell anyone, ever)

If I were shot, the last place on my body I would want to be wounded is the_______.

If I were beaten, the last bone I would want broken is ________________.

A Women's place is in the _________________________.

The one thing I hope this application does not ask me about is ______________.

In the unfortunate event of my untimely death, I would like______________to be contacted.

My greatest fear is__________________________________________.

When I first meet a girl, the first thing I notice about her is her _______________.

NOTE: If the answer to the last question begins with a "B", discontinue the application process and leave the premises. Keep your head low and running in a serpentine fashion is advised.

What do you want to be "IF" you grow up?________________________________.

Have you ever been fingerprinted?______ Had a DNA sample taken and recorded? _________

Your dentist is__________________ Emergency phone #_________________

I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT, UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE,ELECTROCUTION, CHINESE WATER TORTURE AND/OR HOT POKERS.

Signature________________________

Thank you for your interest. Please allow 4-6 years for processing.
You will be contacted in writing if you are approved.
Please do not try to call or write.
(It could cause disqualification and injury to your body.)