APPLICATION FOR PERMISSION
TO DATE MY DAUGHTER
NOTE: This application will be
incomplete and rejected unless accompanied by a complete financial
statement, job history, linage and current medical report from your
doctor. Please be prepared to submit additional information (like
psychological profile and polygraph test) as required.
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Name:___________________________Date of
Birth:______________________
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Height:____________ Weight:____________
I.Q.___________ GPA:_________
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Social Security Number:___________________
Driver's License #:____________
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Boy Scout
Rank:___________________________________________________
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Home Address:____________________________
City:____________________
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State:____________________________ Zip
Code:_______________________
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How far can you run: 40 yards?_______________ 2
miles?___________________
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Do you own a? A)Van____ B)Truck with oversized
tires?_____ C)Waterbed?_____
Do you have an earring, nose ring or belly button ring?__________
Tatoo?_________
NOTE: If you answered YES to any
part of questions #8,
discontinue the application process and leave the
premises!
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In 50 words or
less, what does "LATE" mean to you?__________________________
_________________________________________________________________
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In 50 words or less, what does "DON'T TOUCH MY
DAUGHTER" mean to you?__
_________________________________________________________________
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In 50 words or less, what does "ABSTINENCE"
mean to you?__________________
_________________________________________________________________
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Church you Attend:___________________ How often
do you attend?____________
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When would be the best time to interview your
father, mother and minister?_________
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Answer by filling in the blanks. Please answer
freely. All answers are confidential.
(That means I won't tell anyone, ever)
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If I were shot, the last place on my body I
would want to be wounded is the__________.
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If I were beaten, the last bone I would want
broken is___________________________.
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A Women's place is in the
_________________________.
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The one thing I hope this application does not
ask me about is__________________.
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In the unfortunate event of my untimely death,
I would like______________to be contacted.
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My greatest fear
is__________________________________________.
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When I first meet a girl, the first thing I
notice about her is her___________________.
NOTE: If the answer to the last
question begins with a "B",
discontinue the application process and leave the premises.
Keep your head low and running in a serpentine fashion is
advised.
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What do you want
to be "IF" you grow up?____________________________
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Have you ever been fingerprinted?______ Had a
DNA sample taken and recorded?_________
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Your dentist is__________________ Emergency
phone #_________________________
I SWEAR THAT ALL INFORMATION
SUPPLIED ABOVE IS TRUE AND CORRECT,
UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT
TORTURE,
ELECTROCUTION, CHINESE WATER TORTURE AND/OR HOT
POKERS.Signature________________________Right
- Hand Finger Prints Supplied Please
Thank you for your interest. Please allow 4-6 years for
processing.
You will be contacted in writing if you are approved.
Please do not try to call or write.
(It could cause disqualification and injury to your body.)
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