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 doctor.

 1. Name:__________________________________________Date of Birth:_________________________

 2. Height:___________________Weght:___________________IQ:_____________G.P.A.:____________

 3. Social Security Number:_______________________Drivers License Number:______________________

 4. Boy Scout Rank:______________________________________________________________________

 5. Home Address:___________________________City/State:___________________Zip:______________

 6. Do you have one Male and one Female Parent?______________Number of years married:______________

 7. Do you own a van?________A truck with oversized tires?___________A waterbed?_________________

 8. In 25 words or less, what does LATE mean to you?____________________________________________
 _____________________________________________________________________________________
 9. In 25 words or less, what does DON'T TOUCH MY DAUGHTER mean to you?________________________
 _____________________________________________________________________________________
 10. In 25 words or less, what does ABSTINENCE mean to you ?_____________________________________
 _____________________________________________________________________________________
 11. Church you attend:________________________How often do you attend?________________________

 12. When would be the best time to interview your Father, Mother and Priest?__________________________

 13. Answer by filling in the blank: Please answer freely-all answers are confidential                                                      

   A. If I were shot, the last place on my body I would want to be wounded is in the _____________________   
        B. If I were beaten, the last bone I would want broken is my _______________________________________   
   C. A woman's place is in the ______________________________________________________________  
  D. The one thing I hope this application does not ask me about is _________________________________   
        E. When I first meet a girl the thing I notice about her is __________________________________________  

 14. What do you want to be IF you grow up?___________________________________________________
 15. In case of an Emergency/Accident who do you want to be notified?_______________________________


 I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST
 OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN
 ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED-HOT
 POKERS OR CATTLE PRODS.

_____________________________________                            
Signature/Date                                    

 Thank-you for your interest. Please allow four to six years for processing. You will be contacted in writing if you are approved. Please
 do not try to call or write (since you probably can't and it would cause you injury). If you application is rejected you will be notified
 by two gentleman wearing white ties and carrying violin cases. It would be advisable to watch your back.