Application to date my daughter

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Full Name (first, middle, last) __________________________________
Date of Birth __/___/___ Height_____ Weight_____ IQ_____ GPA______
Social Security #____-____-____ Driver's License #_________________
Boy Scout Rank______________________________________________
Home Address (city, state, zip)__________________________________
_______________________________________________apt. # _______

Do you have one MALE and one FEMALE parent in the home?(y/n)_____
If no, please explain:___________________________________________
Do you own: (A) van? (B) Truck w/oversized tires? (C) Waterbed?
Do you have an earring, nose ring, nipple ring, belly button ring, tattoo? (circle all that apply)
'In 50 words or less... what does the word "LATE" mean to you?
____________________________________________________________
In at least 25 words...What does, "Don't touch my daughter mean to you" ?
_______________________________________________________
In at least 25 words... What does the word "ABSTINENCE" mean to you?
_______________________________________________________________
Feel free to use back of page or attach additional sheets for above questions.

  • Church you attend:____________________
  • How often?_________________

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

Answer the following freely and completely honestly. All Answers are Confidential.

  • If I were shot, the last place on my body I would want to be wounded is________.
  • If I were beaten, the last bone I would want broken is my____________.
  • A woman's place is_______________________________.

4. The "one" thing I hope this application doesn't ask me about is
___________________________________________________________.

5. When I meet a girl, the first thing I notice about her is_____________.*

If the answer to this question begins with T or A Discontinue at this point and leave the premises! Keeping your head low and running in a serpentine fashion is advised.


6. What do you want to be IF you grow up?

I swear that all information supplied above is true and correct to the bestof my knowledge, under penalty of death, a severe beating, dismemberment, torture, crucifixion, electrocution, or a kiss by Hilary Clinton. Any penalty will be decided at the whim of the father.
Signature ________________________________ Date ________
Witness ________________________________ Date ________
Character Reference _____________________ Date ________
Notarized ________________________________ Date ________

This application will be considered incomplete and rejected unless accompanied by a complete financial statement, copy of birth certificate, job history, lineage, and a current medical report from your doctor. Please allow four (4) to six (6) years for processing. You will be contacted in writing if you are approved. Do not call or write as this will only delay the procedure and possibly cause you undue anxiety, if not a visit from the terminator. If your application is rejected, you will be notified in person by two well dressed gentlemen with violin cases. Do not turn your back on them.


Thank you for your interest! GeekPirate.small.png

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