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 medical report from your doctor.
Name:________________________Nickname/Alias:___________________
Date Of Birth:____/____/____
Height:______
Weight:______
I.Q.:______
G.P.A.:________
Soc. Sec.#______-___-_______
Driver's License#____________________
Boy Scout Rank:_____________
Good Standing:Yes_____No_____
Home Address:__________________________________
City/State/Zip_________________________________
Home Phone#: (___)___________
Car Phone#:_______________
Pager#:__________
Do you own
a. Van?____
b. Truck with oversized tires?____
c. Car with a trunk full of speakers?_____
Do you have any of the following:
a. An earring_____
b. nose ring______
c. belly button ring_____
or piercings on any other body parts_____
Explain:__________________________________________
_____
Tattoo?______
(If you answered YES to any of the above questions,
discontinue and leave the premises immediately.)
In 30 words or less, what does "LATE" mean to you?
__________________________________________________
__________________________________________________
______________________________
In 30 words or less, what does "DON'T TOUCH MY
DAUGHTER" mean to you?
__________________________________________________
__________________________________________________
____________________________
Church you attend_____________________
How often______________________
Best time to interview your pastor?_________________
Fill In The Blank. Please answer freely, all answers will be confidential.
a. If I were beaten, the last bone I want to be broken
is:_______________________________________________
_____
b. The one thing I hope this application does not ask
me is:_______________________________________________
_
c. Now answer the question you filled in on
b:________________________________________________
____________________________________________
NOTE: If you have answered any of the previous questions dishonestly (and I will find out),
discontinue application. It is advised that you leave the premises quickly keeping your head low and running in serpentine fashion. I swear that all information provided above is true and correct to the best of my knowledge under penalty of death, dismemberment, electrocution, and/or hot pokers.
_______________________________________
Signature (This means sign your name)
Thank you for your interest. Please allow 4 - 6 YEARS for processing. If your application is approved, you
will be contacted in writing. Please do not call or write, this could cause you unexpected injury.
If your application is rejected, you will be notified by two men wearing white ties and answering to the
names GUIDO and LOUIE.
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