Dating Application


Application to Date My Daughter


Name: Last                              First                            M. Initial               Age          


Address:                                                      County                                        


Religion:                                               #Attendance's in the Last Year           


Parents: Father's Name                               #Marriages            #Years                 


              Mother's Name                             #Marriages            #Years              




1. Do you own or drive a Van?                            

(If so Please Discontinue Filling Out Form)



2. In 50 words or less, describe what NO!!!! Means to you                                     




3. In 50 words or less, describe what LATE!! Means to You                                  




4. Where would you least like To Be SHOT?                                                         


5. Which is the Last BONE You Want Broken?                                                     


6. What do you want to be IF you grow up?                                                          


7. The Place for a WOMAN Is?                                                                              


8. What is MY Daughter's NAME?                                                                        


9.Who besides GOD Should YOU FEAR the most?                                                



Parental Use Only:


Appearance Looks Like:                  Status:

Mel Gibson                                         Accepted:                    

David Letterman                                  Rejected:                    

Pee‑Wee Herman                                  Pending: