Personal Information
Name: |
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Age: |
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Last, First, Middle |
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Address: |
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Street, City, State |
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Religion: |
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Church: |
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Times attended last year: |
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Wikipedia edit count: |
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Commons edit count: |
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Administrator? |
Yes/No |
Arbiter? |
Yes/No |
Founder? |
Yes/No |
Number of Sockpuppets: |
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Family Information
Father’s Name: |
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# Marriages: |
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# Years: |
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Address: |
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Mother’s Name: |
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# Marriages: |
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# Years: |
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Address: |
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Non-Optional Questions
1. |
Do you own or drive a "van"? Yes/No |
(If yes, disregard the remainder of this form) |
2. |
In 50 words or less, describe what "no" means to you: |
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3. |
In 50 words or less, describe what "late" means to you: |
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4. |
Where would you least like to be shot? |
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5. |
Which is the last bone you want broken? |
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6. |
What do you want to be if you grow up? |
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7. |
Complete this sentence: |
“A woman’s place is _______________________” |
8. |
What is my daughter’s name? |
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9. |
Who, besides God, should you fear most? |
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10. |
List Three Reliable References: |
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• Parent’s name: |
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• Phone: |
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• Daughter’s name: |
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• Reason: |
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• Eligible to redate? |
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• Relationship ended |
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Special Note: If accepted, there is a $50 deposit per date. Forfeited if her return is even 1 minute late. If over 30 minutes late, refer to question #5.
Dad’s Use Only
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