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September 03, 2003

Application Form

Received via email:

Application To Date My Daughter

Name: Last:_________________First____________ M.I.:___ Age:_____

Address:___________________________ County:_____________________

Religion:_______________ # of attendances in the last year______

Parent:Father's Name__________#of marriages____# of affairs_____

Mother's Name__________#of marriages____# of affairs_____



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?___________________

10. Is there a history of insanity in your family?______________

11. Have you or any member of your family ever spent time in

12. Are your parents closer relatives to each other than first


Parent's Use Only

Appearance (Looks Like) Status
Mel Gibson___________ Accepted:____________
David Letterman___________ Pending:_____________
Pee Wee Herman____________ Rejected:____________

Posted by Peskie at September 3, 2003 12:00 PM