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NOTE: This application will be incomplete and rejected unless accompanied by a complete financial statement, job history, lineage,current medical report from your doctor and personal reccomendation from your clergy.
NAME______________________ DATE OF BIRTH_____________
HEIGHT_______ WEIGHT________ IQ______ GPA_________
SOCIAL SECURITY #___________ DRIVERS LICENSE #__________
BOY SCOUT RANK AND BADGES__________________________________________
HOME ADDRESS____________________ CITY/STATE___________ ZIP______
Do you have parents? ___Yes ___No
Is one male and the other female? ___Yes ___No
If No, explain:
_____________________________________________________________
_____________________________________________________________________
Number of years they have been married ______________________
If less than your age, explain
____________________________________________________________________
____________________________________________________________________
ACCESSORIES SECTION:
A. Do you own or have access to a van? __Yes __No
B. A truck with oversized tires? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
F. Do you have an earring, nose ring,
pierced tongue, pierced cheek or a belly button ring? __Yes __No
(IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
ESSAY SECTION:
In 50 words or less, what does '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 'ABSTINENCE' mean to you?
______________________________________________________________
______________________________________________________________
REFERENCES SECTION:
Church you attend
___________________________________________________
How often you attend
________________________________________________
When would be the best time to interview your:
father? _____________
mother? _____________
pastor? _____________
SHORT-ANSWER SECTION:
Answer by filling in the blank. Please answer freely, all answers are confidential.
A: If I were shot, the last place I would want shot would be:
____________________________________________________
B: If I were beaten, the last bone I would want broken is my:
____________________________________________________
C: A woman's place is in the:
____________________________________________________
D: The one thing I hope this application does not ask me about is:
____________________________________________________
E. What do you want to do IF you grow up?
______________________________________________________________
______________________________________________________________
F. When I meet a girl, the thing I always notice about her first is:
____________________________________________________
G. What is the current going rate of a hotel room? __________________
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_________________________________________________________
Applicant's Signature (that means sign your name, moron!)
_____________________ _____________________
Mother's Signature Father's Signature
____________________ _____________________
Pastor/Priest/Rabbi State Representative/Congressman
Thank you for your interest, and it had better be genuine and non-sexual. Please allow four to six years for processing.
You will be contacted in writing if you are approved. Please do not try to call or write (since you probably can't, and it would cause you injury). If your application is rejected, you will be notified by two gentleman wearing white ties carrying violin cases. (you might watch your back)
To prepare yourself, start studying 10 Simple Rules for Dating My Daughter.
NAME______________________ DATE OF BIRTH_____________
HEIGHT_______ WEIGHT________ IQ______ GPA_________
SOCIAL SECURITY #___________ DRIVERS LICENSE #__________
BOY SCOUT RANK AND BADGES__________________________________________
HOME ADDRESS____________________ CITY/STATE___________ ZIP______
Do you have parents? ___Yes ___No
Is one male and the other female? ___Yes ___No
If No, explain:
_____________________________________________________________
_____________________________________________________________________
Number of years they have been married ______________________
If less than your age, explain
____________________________________________________________________
____________________________________________________________________
ACCESSORIES SECTION:
A. Do you own or have access to a van? __Yes __No
B. A truck with oversized tires? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
F. Do you have an earring, nose ring,
pierced tongue, pierced cheek or a belly button ring? __Yes __No
(IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
ESSAY SECTION:
In 50 words or less, what does '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 'ABSTINENCE' mean to you?
______________________________________________________________
______________________________________________________________
REFERENCES SECTION:
Church you attend
___________________________________________________
How often you attend
________________________________________________
When would be the best time to interview your:
father? _____________
mother? _____________
pastor? _____________
SHORT-ANSWER SECTION:
Answer by filling in the blank. Please answer freely, all answers are confidential.
A: If I were shot, the last place I would want shot would be:
____________________________________________________
B: If I were beaten, the last bone I would want broken is my:
____________________________________________________
C: A woman's place is in the:
____________________________________________________
D: The one thing I hope this application does not ask me about is:
____________________________________________________
E. What do you want to do IF you grow up?
______________________________________________________________
______________________________________________________________
F. When I meet a girl, the thing I always notice about her first is:
____________________________________________________
G. What is the current going rate of a hotel room? __________________
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_________________________________________________________
Applicant's Signature (that means sign your name, moron!)
_____________________ _____________________
Mother's Signature Father's Signature
____________________ _____________________
Pastor/Priest/Rabbi State Representative/Congressman
Thank you for your interest, and it had better be genuine and non-sexual. Please allow four to six years for processing.
You will be contacted in writing if you are approved. Please do not try to call or write (since you probably can't, and it would cause you injury). If your application is rejected, you will be notified by two gentleman wearing white ties carrying violin cases. (you might watch your back)
To prepare yourself, start studying 10 Simple Rules for Dating My Daughter.
