Application For Permission To Date My Daughter

APPLICATION TO DATE OUR DAUGHTER

Place your Photo here.

Name: ___________________________

Date of birth: ___________________________

Address: ___________________________

Phone Number: ___________________________

S.S. Number: ___________________________

Boy Scout rank: ___________________________

Mother's name: ___________________________

Father's name: ___________________________

Do you own any of these items:

- motorcycle
- muscle car or sports car
- earing
- van
- firearm
- tattoo-truck with oversized tires
- exotic pet, such as a snake
- electric guitar

[If you checked any of these items, discontinue application and leave immediately.]

4. Do you:

Do you smoke? Yes / No

Do you drink? Yes / No

Do you gamble? Yes / No

Have you ever been arrested? Yes / No

Do you ever drive over the speed limit? Yes / No

Have you ever seen Elvis? Yes / No

Have you ever seen a UFO? Yes / No

Have you ever seen Elvis in a UFO? Yes / No

[If you answered Yes to any of the preceeding questions, discontinue application and leave immediately.]

5. Preferred dating activity:

- Walk in the park
- Watch a School play
- Minature Golf 6.

In 50 words or less, tell exactly what the words "Don't be late" mean to you.

___________________________________________

___________________________________________

You must attach a complete police record and latest diploma or transcript.

8. Signatures
- Your Signature

- Parents' signatures

- Police Chief's signature

[Please allow 4 to 6 years for processing. Any unanswered questions will result in forfeiture of application. Apply at your own risk.]