DAVE'S APPLICATION TO DATE ALISON

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.

Biographical Information

What is your name? __________________

What is your email address? __________________

Home address: __________________

City/Province:__________________

Postal Code:_____________

Birthdate:________________

Height:______________Weight:______________ IQ:______ Grade finished:___________

Social Insurance Number: _________________

Drivers Licence Number: _________________

Boy Scout Rank: _________________

BSA Badges: __________________

Church you attend: __________________

How often you attend: __________________

Do you have ONE male and ONE female parent? Yes No (please circle) If NO, please explain:

_____

Number of years they have been married: _________________

If less than your age, explain: ____



Other Information

Which of the following do you own? (Check all that apply.)
___Sports car that will do 120 in 4 seconds.
___Van
___Motorcycle
___Truck With Oversized Tires
___Waterbed
___Earring(s)
___Other body piercing
___Tattoo
(IF YOU OWN ANY FROM THE PREVIOUS PAGE, DISCONTINUE APPLICATION AND LEAVE PREMISES....................NOW!)

Have you ever been stopped, questioned or apprehended by an officer of the law?_______
If yes, explain giving date, place, officer's name, badge # and copy of the documents to back your story.

____________________

Please provide certified copies of birth certificate, social security card, driver's license test, driving record with explanation of all incidences listed including officers' and judges' names, copies of all citations with proof of fulfilling the required sentences and payment of all fines.

How fast do you drive in a 60kmh zone?_____________ 100kmh zone?_______________

Do you ever drive over 100kmh?_____________

What is the fastest you have ever driven any motorized vehicle?_____________________

Is your vehicle equipped with safety belts (that work & are used properly)?______________

Radar detector or CB radio?___________

AM/FM radio?________________________

Tape and/or CD player?__________

What volume setting do you routinely use?___________

What is the proper automobile etiquette when you see an approaching funeral procession?

_______________

What is the speed limit on my street?________________

On main streets?______________

On minor highways?________________

On major highways?______________


Please answer the following questions freely, all answers are confidential.

Short Answer


A woman's place is in the: ____________

The one thing I hope this application does not ask me about is: ____________

When I first meet a girl, the thing I notice about her first is: ____________

NOTE: If the answer to the last question begins with T or A, discontinue. Leaving premises keeping your head low and running in a serpentine fashion is advised.


Essay Questions

In 50 words or less answer the following questions.

What does LATE mean to you? _____________

What does DON'T TOUCH MY DAUGHTER, mean to you? ____________

What does ABSTINENCE mean to you? ____________

What do you want to do IF you grow up? ____________


References

List three references who you have known for at least two years and are not relatives.

Name:_________________________

Address:______________________

Phone:________________________


Name:_________________________

Address:______________________

Phone:________________________


Name:_________________________

Address:______________________

Phone:________________________


When would be the best time to interview your:

Father:_______________________

Mother:_______________________

Priest:_______________________

Parole officer:_______________



I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND BIG AUNT BERTHA'S KISS TORTURE.



_________________ _____________
Signature (that means sign your name) Date(today's date, not my daughter's name)

Thank you for your interest. Please allow four to six years for processing. You will be contacted in writing if you are approved. Please do not try to call or write (since you probably can't, and it would cause you injury). If your application is rejected, you will be notified by two gentleman wearing black shirts and white ties carrying violin cases (you might want to watch your back).

Have a nice day.

If you're up to it now, click on the popcorn machine to see MOM!