APPLICATION TO DATE MY DAUGHTER

Name: Last_______________ First_______________ Middle Initial_____ Age ______
Address ______________________ City _______________Phone_______Cell_______
Planet__________Religion____________Church____________ License # ___________
Make of Car__________Model___________License Plate #_______________________
# of Accidents (ever)___________# of Tickets (ever)__________
_____________________________________________________


YOUR FAMILY INFORMATION


Father’s Name_______________# Marriages_____# Years______
Address ____________________Aliases?____________________
Mother’s Name______________# Marriages_____# Years______
Address____________________Aliases?_____________________
______________________________________________________

 

1. Do you own or drive a van? Yes/No (If “yes”, discontinue filling out this form.)

2. In 50 words or less, explain what the word “NO” means to you:_______________
__________________________________________________________________
__________________________________________________________________
3. In 50 words or less, explain what the word “LATE” means to you:_____________
__________________________________________________________________
__________________________________________________________________
4. Where would you least like to be shot?___________________________________
5. Which is the last bone you want broken?__________________________________
6. What do you want to be, IF you grow up?_________________________________
7. Please complete this sentence: “ A Woman’s place is.________________________
8. What is my daughter’s
name?___________________________________________
9. Who, besides God, should you fear most?_________________________________
10. Do you have
medical coverage? Yes/No Where?____________________________

11. Does your underwear have pictures or words on the outside? Yes/No
12. Do you plan to take a shower, shave, and use deodorant , comb your hair, brush your teeth, and put on a clean shirt before you come for my daughter? Yes/No
13. Do you now, or have you ever done drugs? Yes/No (If yes stop filling out this form)
14. Do you plan to be buried or cremated? Buried?_/ Cremated?_________________


LIST OF REFERENCES (Last three girls you dated)


Girls Name Fathers Name Reason for breakup
And Phone number

1.___________________ ___________________ ___________________

2.___________________ ___________________ ___________________

3.___________________ ___________________ ___________________
Special Notice: If accepted, there will be a $50 deposit for background check when you pick up my daughter. If you are one minute late, the deposit will be forfeited. If you are more than 30 minutes late, refer to question # 14.

15. Have you ever been arrested for anything EVER? (If yes, explain in detail When, Where and Why?)
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

16. Has anyone that you hang out with ever been arrested for anything EVER? (If yes, explain in detail When, Where, and Why?)
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

17. Do you have any kids? Yes/No    # Kids _______
( Note: if more than 1 before the age of 18 discontinue filling out this form )


18. Do you drink alcohol? Yes/ No
18B. Again, and this is, your very last chance. DO YOU NOW, OR HAVE YOU EVER DONE DRUGS? YES/ NO? If yes, explain what kind of drugs? And last date of last time you did drugs.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

19. Do you hit girls? Yes/ No?
19B. Have you ever hit a girl? Yes/ No?
20. What do you think might happen if you should ever hit my daughter? (Explain in detail)
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

21.Do you, or does anyone in your family have any kind of mental problems? Yes/No? If yes,explain.______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
(After your application is filled out completely, and if everything checks out good. You will be notified of our answer within 24 hours if you will be allowed to date my daughter.)

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Comments:

kayja...
Feb. 1, 2008 at 10:52 PM LOL thats a great idea

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jennb...
Feb. 2, 2008 at 12:56 AM I am saving this one! They will never have a chance! Her daddy will be cleaning his gun like that country song all night long! LOL!

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