Application to Date Daughter

Important: Read all instructions, disclaimers, waivers, provisions, and questions completely before filling out this form. Use Tab to move between form fields.

Note: This application must be printed out and submitted in person. Appropriate interview attire is highly recommended. This application must be accompanied by a non-refundable $50 application fee and a $120 security deposit which will be returned if 1) this application is denied, or 2) at the end of the date if all terms and conditions have been met. Required recommendations must be submitted at time of application and will be verified. A missing recommendation will count 10 points against you. Multiple applications will be entertained; however, the application fee is subject to a multiplier equal to the Fibonacci Series value for the sequence number of the application. This application covers one date only and must be resubmitted unless waived in writing. Submission of this application constitutes acceptance of our privacy policy.

Questions should be filled out to a level of detail and completeness that you feel necessary to support your application without omitting any negative, scandalous, offensive, or derogatory information or any other information that might be adverse to acceptance of this application, whether specifically asked for or not. Application will consider not only the answers submitted, but the level of detail, specificity, and forthrightness of the material supplied. Applicant is required to submit any information that might be evaluated adverse to this application whether or not any question is asked about that information.

Any instructions that are contradictory, confusing, incomplete, or incomprehensible should be regarded as a test of your intelligence and ability to resolve issues.

Application is not considered complete until all supplemental materials and fees have been submitted including fingerprints, drug test results, and STD clearance. Miscalculation of fees will trigger a forfeiture of fees submitted. Application must be accompanied by an handmade gift for my daughter reflective of your perception of her quality, nature, and value.

Submission of this application, as evidenced by physical delivery of a printed copy of this application with all supporting documentation, fees, and deposits, constitutes an agreement to waive all damages, civil or criminal, caused by me upon your body or property, including, but not limited to bruising, bleeding, loss of limb, eye, or life, mayhem, carnage, and/or destruction of vehicles or other property in the event that the terms of this agreement are not followed or in the event of dishonesty in filling out this form. In that event, you specifically waive the right to have your body found. You agree that you are solely responsible for any damages to third parties deriving from any enforcement action under this contract and will indemnify me for any judgement pertaining to any collateral damage obtained by any third party. This specifically includes damages from automatic weapons fire and explosives.

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So far your chances are:


(Yes. I know it, but if you don't, forget it.)
Your Information
First Name: Middle Name: Last Name: Generation:


Aliases / AKAs / Alternative Names known to Law Enforcement or Credit Bureaus

Use a separate line for each entry
Your Age:
Age you think my daughter is:


Your Gender:
Bathing Habits:
Will your parents verify this?


Your Address: Apt.
City: State Zip -
Name(s) of roommates

Home Phone:
Cell Phone: GPS Trackable?:

All phone numbers will be verified prior to any date. During the date, failure to answer your cell phone will trigger a forfeiture of deposit. Answering your home phone during date will also trigger a forfeiture.


Number of Children:
I am 100% current on any child support responsibilities that I might have.


Social Networks. Include name of network, your ID, and the URL of your profile.


Instant Messenger IDs


Your Family Information


Your Father's Contact Information
I live at the same address as my father
Street Address Apt.
City State ZIP -
Father's Phone:
Father's Cell:
Father's email:
Name(s) of live-in females

Do not include your mother as a live-in


Your Mother's Contact Information
I live at the same address as my mother
Street Address Apt.
City State ZIP -
Mother's Phone:
Mother's Cell:
Mother's email:
Name(s) of live-in males

Do not include your father as a live-in


Your Guardian's Address
Name (Male)
Name (Female)
I do not have a guardian
Street Address Apt.
City State ZIP -
Guardian's Phone:
Guardian's Cell:
Guardian's email:


Number of Brothers Full Half Step
Number of Sisters Full Half Step
Birth Order


In 200 words or less, describe what you would do to anyone who hurt one of your sisters

Using the above as a template, state your expectations of what would happen to anyone who hurt my daughter


Professional Contacts
Physician: Phone:
Dentist: Phone:
Mortician: Phone:
Preferred disposition of body:


Your School
Street Address
City State ZIP -
Grade Level
GPA (average for last 3 years)
Principal's Phone:
Application must be accompanied by certified school transcripts and notarized statement from Principal/President/Dean that he/she would permit you to date their daughter.


Drivers License Number: Class:
Date first licensed:


If none, state transportation plans

Be advised: I will be confiscating your license and registration on any first date to be held against the safe and timely return of my daughter. Therefore, this should be filled in.


Tickets Received Since Licensure:
Accidents Involved In Since Licensure:
Fault Accidents:

Application must be accompanied by certified copy of Driving Record

Vehicle: Year
Vehicle Seating Type: Mileage at last tune up
GPS Trackable?: Last time it 'didn't start':
Last time you personally performed an oil change on your vehicle:

Vehicle service record claims will be compared to dealer records for this VIN.


Other Required Information
Credit Score:
Myers-Briggs Type:


Educational Plans. Be specific and cover planned fields of study and planned degree programs through the post-doctoral level.


Occupational Plans. Be specific and cover at least the next 10 years


Church: Phone
Pastor: Phone
Youth Pastor: Phone

Include in your supporting documentation letters of reference from your pastor and youth pastor. They should specifically address whether they would permit you to date one of their own daughters.




Athletic Involvement

Include in your supporting documentation letters of reference from your coaches. They should specifically address whether they would permit you to date one of their own daughters.


Community Involvement


Police Involvement


Have you ever been accused of any crime:
Describe each incident, outcome of trial or plea bargain, and sentence.

Do you have any record that has been sealed or expunged?


Attorney: Phone:
Probation Officer: Phone:
Therapist: Phone:

Attach certified copy of Criminal Record and statement on Attorney's letterhead that s/he would permit you to date Attorney's daughter. Attach statement from Probation Officer that s/he would permit you to date Probation Officer's daughter.


Tattoos and Identifying Marks


Blood Type:

Attach Red Cross donation record.


TypeInsurance CoPolicy NumberClaims Phone
Car Insurance
Medical Insurance
Life Insurance
Psychiatric Insurance


Favorite Pickup Line


Previous Girlfriends

Note all previous girlfriends for the last 8 years. Include in your supplemental materials Letters of Recommendations from each. For each specify the reason for breaking up. Note any Child Support allegations or judgements.


Current location of your belt/top of pants relative to your waist (at the thinest part): inches

Note that at the time of any date, pants not found at an appropriate level are subject to being fastened at the waist with an industrial staple gun.


Attitude toward Safe Sex.


On the reverse side and in handwriting using fountain pen, describe the nature and intent of the proposed date. Be specific and use standard essay style. Descriptions of less than 550 words will not be considered. Neatness and grammer count. Descriptions in Latin, Greek, Hebrew, Coptic, Ugaritic, and/or Acadian will be given additional consideration. Using Microsoft Project (or open source equivilent), show time, budget, and resource deployment associated with this plan. Minor variation will be assessed at $2/minute. Major variation or variation not covered by deposit will generate a police record. Transcribe all of the above here.


On a separate attached paper, utilizing any technology predating 1800, write a 500-600 word essay, in English, on why I should NOT permit you to date my daughter. Be specific, complete, and persuasive. Transcribe all of the above here.


Refute the above argument. You may use any language not previously utilized. Essay must be hand encoded for the web. Provide URL to where this essay is posted. Essays posted to social networking sites will not be considered. Essays will be evaluated for content and appearance (both of graphic design and adherence to source coding standards). Use this opportunity to show mastery of W3C standards, client and server side processing, and AJAX. RDF/OWL description blocks are expected. Each paragraph of your refutation should be worked into verse and the whole should represent a sampler of poetic styles through history. Be creative. Transcribe all of the above here.


Identify all rhetorical devices within your refutation. Transcribe all of the above here.


What is your favorite video game:
Preferred gaming system:
Favorite board game:
Last time you played:
Favorite Movie:
Usual Theater:


Using concepts from both Mereological Calculus and Calculus of Variations, describe your fate should the above described date not proceed along the plan.


Ethics question: A young scumbag takes indecent liberties with an innocent young girl. Sometime later, the scumbag is tied to a tractor by masked men and beaten senseless with 2x4s and lead pipes. Does the girl's father have an obligation to send flowers to the hospital room or mortuary? Write answer and seal in envelope. Telepathically convey response to my daughter who will recite it to me to determine that we all understand one another. Variation between her answer and your written answer will count against you.


Describe German troop movements with respect to the Maginot Line. Describe it both the military strategy and a pickup strategy.



Describe what Chivilry means to you and how you have applied it today. Give examples.


For each listed occasion, indicate whether it is 'Mandatory,' 'Appropriate, but optional,' 'Odd,' or 'Inappropriate' to send flowers.
Death of a family member
After a silly, small argument
Arbor Day
Laid off
New Job
Three months after breakup
Labor Day
My Daughter's Mother's Birthday
For the 2nd time after the 1st Date
For the 3rd time after the 1st Date
To say 'Sorry' immediately after a bad arguement

A napkin


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For your consideration

Feeling Rejected?
You should be!
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Get Help!
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Get a Job!
Unemployed guys are 90% less likely to land the girl of their dreams. Get it through your head that a girl is more likely to say 'yes' to a dinner at L’Escalier at the Florentine than In-n-Out Burger.
Latin? Greek? Ugaritic?
Some idiot wants you to fill out an application to date his daughter in some weirdo language. Do you really think that he knows how to read it? Find out what HE really knows! Tell him to blow it out his ear in Accadian! Assert your manhood in Swahili! Describe your lusts for his daughter in Pirahã! Do you think he will really know?