Application For Permission To Date My Daughter Note: Please be prepared to submit additional information e.g. psychological profile, DNA sample and submission to polygraph exam. 1. Name______________________________ Date of Birth____/____/______ 2. Height____ ft.____ in. Weight______ Lbs. I.Q.______ GPA_______ 3. Social Security Number___/__/____ Drivers License: State___ Number_____________ 4. Home Address______________________________City_________________State_____ 5. Boy Scout Rank_____________________ 6. How fast can you run 40 yards______ sec. Two Miles______ min. 7. Church you attend ______________________ How often? ___________________ 8. In 50 words or less, Explain what “DON’T TOUCH MY DAUGHTER” means to you. ________________________________________________________________________________________________________________________________________________________________________________________________________________________ 9. In 50 words or less, Explain what “Late” means to you. ________________________________________________________________________________________________________________________________________________________________________________________________________________________ 10. Complete the following sentences: a. If I were to be shot, the last place I would want to be shot is in the _______________ b. If I were to be beaten, the last bone I would want to be broken is _______________ c. The one thing I hope this Application does not ask is____________________________________________________________________ d. In the unfortunate event of my untimely death, I would like my ashes scattered _____________________________________________________________________ e. My greatest fear is _____________________________________________________________________ 11. What do you want to be if you grow up?_______________________________________ 12. Have you ever been fingerprinted? Yes____ No____ 13. Do you have any Identifying marks? e.g. birth marks, scares, tattoos Yes____ No____ 14. My Dentist is_______________________________ City_______________ State_____ I hereby swear that all the information supplied above is true and correct to the best of my knowledge under penalty of Death and or Dismemberment. Signed ____________________________________________ Thank you for your interest! Please allow 4 to 6 years for processing. You will be contacted in writing if you are approved. Please do not call, write, or E-mail. Any attempts at contact during the processing of this application could be hazardous to your health and /or cause serious personal injury.
Posted on: Mon, 08 Dec 2014 14:30:20 +0000
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