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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 current medical report from your physician.

Name: Date of Birth:
Height:  Weight: IQ: GPA:
Social Security Number: Driver's License Number:
Boy Scout Rank: Telephone:
Home Address:
City: State: Zip:


  1. Do you have one male and one female parent?  ____
    If "No", explain:

  2. Number of years your parents have been married:  ____
    Any brothers or sisters?  ____
    Are they normal?  ____

  3. Do you own or have access to a van?  ____
    A truck with oversize tires?  ____
    A waterbed?  ____

  4. Do you have an earring, nose ring, or belly button ring? ____ 

  5. Do you have a tattoo? ____

    If you have answered YES to #3, #4 or #5, discontinue application and leave immediately.

  6. In fifty words or less, what does Late mean to you?

  7. In fifty words or less, what does Don't touch my daughter mean to you?

  8. In fifty words or less, what does Abstinence mean to you?

  9. In fifty words or less, what does Real Pain mean to you?

  10. Church/Temple you attend: ____________________________

    How often do you attend: ____________________________

  11. When would be the best time to interview your mother, father and priest/rabbi? ____________________________

  12. Please fill in the blanks:

    1. If I were shot, the last place on my body I would want wounded would be my ____________________________

    2. If I were beaten, the last bone I would want broken would be my ____________________________

    3. A woman's place is in the ____________________________

    4. The one thing I hope this application doesn't ask is ____________________________

    5. When I meet a girl, the one thing I always notice about her first is ____________________________

      Note: If answer begins with "T" or "A", discontinue and leave premises - keeping your head low and running in a serpentine fashion is advised

  13. What do you want to be if you grow up?


I swear that all the above information is correct to the best of my knowledge under penalty of death, bodily harm, dismemberment, torture or mental abuse.

Signature of applicant _________________________________

Signature of father _____________________________________

Signature of mother ____________________________________

Signature of priest/rabbi ___________________________________

Signature of State Representative _________________________

Thank you for your interest, and it had better be genuine and non-sexual. Please allow 4-6 years for processing. You will be contacted in writing if approved. If denied, please never apply again. Don't call me, I'll call you.

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