 Application 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 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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