APPLICATION FOR PERMISSION TO DATE MY DAUGHTER 

 This application will be Incomplete and rejected unless accompanied by a complete financial statement, lineage history and current medical report from a doctor of my choosing.                  DATE OF BIRTH________________ NAME:___________

HEIGHT:                     WEIGHT:                                                   IQ:          GPA:_______DL#___________SOC.SECURITY  :                                         

BOY SCOUT RANK:                                           SUNDAY SCHOOL ATTENDED:________________ Do you have one MALE and one FEMALE parent?__________If "NO" explain on back of this page

Number of years parents married                   Any brothers or sisters?                 Are they normal?_____________

Do you own or have access to: a van _________ A truck with oversized tires                                     A waterbed_________ Do you have an earring, nose ring or belly ring?_____________ A tattoo?___________

(if yes to any of these, discontinue application and leave premises immediately)

In 50 words or less, what does the word 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 the word “NO" mean to you ? ___________________________________________

In 50 words or less, give your definition of "Real Pain": _________________________________________________

Church you attend:                                                                                                          how often do you attend: S, M, T, W, Th, F,

When would be the best time to interview your mother, father and minister?________________________________ Please fill in the blank:

A    If I were shot, the last place on my body I would want wounded would be my ______________

B    If I were beaten, the last bone I would want broken would be my_________________________

C    A Woman's place is in the _________________________________________________________

D    The one thing I hope this application doesn't ask is________________________________________

E   When I meet a girl  the first thing I always notice is her_____________________________________

F  What do you want to be if you grow up?____________________________

I swear that all the above information is correct to the best of my knowledge under penalty of death, bodily harm dismemberment, torture or natural disaster.

Signature of Applicant____________________________________

Signature of Father_________________________                      Signature of Mother _____________________________________

Signature of Minister_____________________________________

Signature of State Representative

Thank you for your interest. Please allow 4-6 weeks for processing. You will be contacted in writing if approved. If denied, please never apply again. Don’t  call  me!  I’ll call you!