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. NAME________ _________ _________ _________ __ DATE OF BIRTH_______ ______ HEIGHT______ _____ WEIGHT______ ______ IQ__________ GPA_________ ____ SOCIAL SECURITY #___________ ______ DRIVERS LICENSE #___________ _____ BOY SCOUT RANK AND BADGES______ _________ _________ _________ _________ HOME ADDRESS_____ _________ _________ CITY/STATE__ _________ ZIP______ Do you have parents? ___Yes ___No Is one male and the other female? ___Yes ___No If No, explain: ____________ _________ _________ _________ _________ _________ ____ ____________ _________ _________ _________ _________ _________ _________ ___ Number of years they have been married ____________ _________ _________ If less than your age, explain ____________ _________ _________ _________ _________ _________ _________ __ ____________ _________ _________ _________ _________ _________ _________ __ ACCESSORIES SECTION: A. Do you own or have access to a van? B. A truck with oversized tires? C. A waterbed? D. A pickup with a mattress in the back? E. A tattoo? __Yes __No __Yes __No __Yes __No __Yes __No __Yes __No

F. Do you have an earring, nose ring, __Yes __No pierced tongue, pierced cheek or a belly button ring? (IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.) ESSAY SECTION: In 50 words or less, what does 'LATE' mean to you?

____________ _________ _________ _________ _________ _________ _____ ____________ _________ _________ _________ _________ _________ _____ In 50 words or less. Please answer freely. What do you want to do IF you grow up? ____________ _________ ______ ____________ _________ _________ _________ _________ _________ _____ . all answers are confidential. what does 'DON'T TOUCH MY DAUGHTER' mean to you? ____________ _________ _________ _________ _________ _________ _____ ____________ _________ _________ _________ _________ _________ _____ In 50 words or less. what does 'ABSTINENCE' mean to you? ____________ _________ _________ _________ _________ _________ _____ ____________ _________ _________ _________ _________ _________ _____ REFERENCES SECTION: Church you attend ____________ _________ _________ _________ _________ ___ How often you attend ____________ _________ _________ _________ _________ When would be the best time to interview your: Father? ____________ _ Mother? ____________ _ Pastor? ____________ _ SHORT-ANSWER SECTION: Answer by filling in the blank. 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. the last place I would want to be shot would be: ____________ _________ _________ _________ _________ _________ _____ B: If I were beaten. A: If I were shot.

When I meet a girl. What is the current going rate of a hotel room? ____________ ______ I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH AND DISMEMBERMENT. Daddy's Rules for Dating Your dad's rules for your boyfriend (or for you if you're a guy): Rule One: If you pull into my driveway and honk you'd better be delivering a package. To prepare yourself. and I will not object. However. I want to be fair and open minded about this issue. I will take my electric nail gun and fasten your trousers securely in place to your waist. moron)! ____________ _________ _________ _ Mother's Signature ____________ _________ _________ _ Pastor/Priest/ Rabbi ____________ _________ _________ __ Father's Signature ____________ _________ _________ __ State Representative/ Congressman Thank you for your interest. Please don't take this as an insult. Still. because you're sure not picking anything up. in order to ensure that your clothes do not. start studying Daddy's Rules for Dating.____________ _________ _________ _________ _________ _________ _____ F. Rule Three: I am aware that it is considered fashionable for boys of your age to wear their trousers so loosely that they appear to be falling off their hips. Please allow four to six years for processing. If you cannot keep your eyes or hands off of my daughter's body. Rule Two: You do not touch my daughter in front of me. You may glance at her. so long as you do not peer at anything below her neck. so I propose this compromise: You may come to the door with your underwear showing and your pants ten sizes too big. but you and all of your friends are complete idiots. . I will remove them. the thing I always notice about her first is: ____________ _________ _________ _________ _________ _________ _____ F. ____________ _________ _________ _________ _________ _________ Applicant's Signature (that means sign your name. in fact come off during the course of your date with my daughter.

sofas. If you make her cry. movies which feature chain saws are okay. we should talk about sports. I will make you cry. like changing the oil in my car? Rule Eight: The following places are not appropriate for a date with my daughter: Places where there are beds. Places where there is dancing. But on issues relating to my daughter.zipped up to her throat. I may appear to be a potbellied. or happiness. midriff T-shirts.Rule Four: I'm sure you've been told that in today's world. why don't you do something useful. Speak the perimeter password. when it comes to sex. When my Agent Orange starts acting up. or anything softer than a wooden stool. balding. and more than an hour goes by. The camouflaged face at the window is mine. Do not trifle with me. Movies with a strong romantic or sexual themes are to be avoided. There is no need for you to come inside. and the only word I need from you on this subject is: 'early. and I will kill you. Rule Five: It is usually understood that in order for us to get to know each other. announce in a clear voice that you have brought my daughter home safely and early. the voices in my head frequently tell me to clean the guns as I wait for you to bring my daughter home. Instead of just standing there. or anything other than overalls. do not sigh and fidget. Rule Ten: Be afraid. Rule Seven: As you stand in my front hallway. I have a shotgun. Let me elaborate. merciless god of your universe. with many opportunities to date other girls. and other issues of the day. once you have gone out with my little girl. Please do not do this. a process than can take longer than painting the Golden Gate Bridge. the whole truth and nothing but the truth. If you want to be on time for the movie. Places where the ambient temperature is warm enough to induce my daughter to wear shorts. a shovel. My daughter is putting on her makeup. tank tops. Hockey games are okay. I am the barrier. I am the all-knowing. Be very afraid. It takes very little for me to mistake the sound of your car in the driveway for a chopper coming in over a rice paddy near Hanoi. waiting for my daughter to appear. and five acres behind the house. sex without utilizing a 'Barrier method' of some kind can kill you. politics. you will continue to date no one but her until she is finished with you. Rule Nine: Do not lie to me.' Rule Six: I have no doubt you are a popular fellow. This is fine with me as long as it is okay with my daughter. The only information I require from you is an indication of when you expect to have my daughter safely back at my house. As soon as you pull into the driveway you should exit the car with both hands in plain sight. middle-aged. Old folks homes are better. If I ask you where you are going and with whom. dimwitted has-been. and a goose down parka -. you should not be dating. Otherwise. you have one chance to tell me the truth. a sweater. holding hands. . Places where there is darkness. then return to your car.