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| Application For Permission To Date My Daughter Note: This Application will must be filled out completely or it will be rejected; it must be accompanied by a complete financial statement, job history, genealogy history; a complete criminal and medical background check must be submitted as required: We reserve the right to have drug screening; psychological profile; or polygraph test performed as we see fit. MUST BE FILLED OUT COMPLETELY! NAME___________________________. DATE OF BIRTH____________/___/_________. HEIGHT______ WEIGHT________ I.Q._____ GPA._________. SOCIAL SECURITY #____-______-_____ DRIVERS LICENSE #______-_____-_____. BOY SCOUT RANK __________ HOME ADDRESS__________________________________ CITY / STATE_______________ ZIP__________. HOME PHONE___-_____-_______ WORK PHONE____-_____-_____ . PARENT'S ADDRESS IF NOT LIVING AT HOME ________________________ CITY / STATE __________ ZIP____________ THEIR HOME PHONE#____-______-_____ THEIR WORK PHONE#_____-____-_____(FATHER) _____-____-_____(MOTHER) CHURCH THAT YOU ATTEND NAME____________________________ ADDRESS________________________________________________ CITY / STATE___________________________ ZIP____________. DISQUAIFALICATIONS: DO YOU OWN: A VAN ?_______ A TRUCK WITH OVERSIZED TIRES ?______ A FAST CAR ?________ A WATERBED ?_____ DO YOU HAVE EARRING; NOSE RING;BELLY BUTTON RING ?______ TATTOO ?_____ BOOM BOX ?______. (IF YOU ANSWERED YES TO ANY OF THESE QUESTIONS; DISCONTINUE THIS APPLICATION AND LEAVE THE PREMISES NOW.) IN 50 WORDS OR LESS , WHAT DOES LATE MEAN TO YOU? IN 50 WORDS OR LESS , WHAT DOES DO NOT TOUCH MY DAUGHTER MEAN TO YOU ? IN 50 WORDS OR LESS ,WHAT DOES ABSTINENCE MEAN TO YOU ? WHAT WOULD BE THE BEST TIME TO INTERVIEW YOUR FATHER,MOTHER,AND MINISTER ? (ANSWER FILLING IN THE BLANKS, PLEASE ANSWER ALL QUESTIONS FREELY . ALL ANSWERS WILL BE CONFIDENTIAL.) IF I WERE SHOT , THE LAST PLACE ON MY BODY I WOULD WANT TO BE WOUNDED IS THE _______________. IF I WERE BEATEN,THE LAST BONE IN MY BODY I WOULD WANT BROKEN IS_____________. THE ONE THING I HOPE THIS APPLICATION DOES NO ASK ME ABOUT IS_______________. IN THE UNFORTUNATE EVENT OF MY UNTIMELY DEATH ,I WOULD LIKE________________ TO BE CONTACTED. MY GREATEST FEAR IS_______________________? WHEN I FIRST MEET A GIRL THE ONE THING I NOTICE ABOUT HER IS________________? (NOTE : IF THE ANSWER TO THE QUESTION STARTS WITH A B, DISCONTINUE AND LEAVE PREMISES-KEEPING HEAD LOW AND RUN AWAY IN A SERPENTINE FASHION.) WHAT DO YOU WANT TO BE WHEN YOU GROW UP?_______________. HAVE YOU EVER BEEN FINGERPRINTED ?_____________________. HAD A DNA SAMPLE TAKEN AND RECORDED ?__________________. YOUR DENTIST'S NAME IS_________________________________ EMERGENCY # IS___________________. I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, AND RED HOT POKERS. __________________________________________ Signature (that means sign your name) NOTE: AFTER SUBMITTING YOUR APPLICATION, PLEASE ALLOW 4-6 YEARS FOR PROCESSING. |
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