Application

(Click on 'Application Form', for a free printable PDF version of the form you see below. This will open a new window. If you cannot open PDF files, click on 'Adobe Reader' to open a new window at their website and their free download.)

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? __Yes __No

B. A truck with oversized tires? __Yes __No

C. A waterbed? __Yes __No

D. A pickup with a mattress in the back? __Yes __No

E. A tattoo? __Yes __No

F. Do you have an earring, nose ring, pierced tongue, pierced cheek or a belly button ring? __Yes __No

(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, 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: (supply numbers)

father? _____________

mother? _____________

pastor? _____________

past girlfriends?__________

SHORT-ANSWER SECTION:

Answer by filling in the blank. Please answer freely, all answers are confidential.

A: If I were shot, the last place I would want shot would be:

______________________________________________________________

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. What do you want to do IF you grow up? ___________________________

______________________________________________________________

______________________________________________________________

F. When I meet a girl, the thing I always notice about her first is:

____________________________________________________________

(NOTE: If the answer to #F begins with “T” or “A”, discontinue and it is advised you leave the premises right now, keep your head low, and keep running.)

G. 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, DISMEMBERMENT,NATIVE AMERICAN ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.

___________________________________________________
Applicant's Signature (that means sign your name!)

_______________________________
Father's Signature

________________________________
Mother's Signature

_______________________________
State Congressman/Representative

________________________________
Pastor/Priest/Rabbi


Thank you for your interest in my daughter. It had better be genuine and non-sexual. Please allow four to six years for processing. You will be contacted in writing if you are approved. Don’t call us; we’ll call you. Do not try to call or write (since you probably can't anyway). If your application is rejected, you will be notified by two gentleman wearing white ties carrying violin cases.

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