Dating Application
Full Name (As on birth certificate): _______________
Name that you tell everyone is yours: _______________
Nick Name(s): __________________________________________________________________
Have you ever been arrested: Yes ____ No ______
If so how many times: ___________
For what? _____________
While in jail were you attracted or did you have sex with any of your inmates? Yes ____ No ____
How old are you: _________
What is your birthdate: _________
Do you do drugs? Yes ____ No ____
Do you sell drugs? Yes ____ No ____
Do you drink(alcohol)? Yes ____ No ____
Do you know how to mix drinks? Yes ____ No ____
Do you take advantage of people when they are drunk? Yes ____ No ____
Will you take advantage of me when I am drunk? Yes ____ No ____
If I am drunk and make an idiot out of you, will you get mad at me? Yes ____ No ____
Are you an abuser? Yes ____ No ____
Do you want me to abuse you? Yes ____ No ____
Do you have hidden body parts or piercings I have not seen yet? Yes ____ No ____
If so, where? _________________________________
Did you pierce them yourself or have them professionaly pierced? ___________________
For the duration of this potential relationship will you continue to have the same sexual preference?
Yes____ No ____
Will your parents like me? Yes ____ No ____
Will your parents hate me? Yes ____ No ____
Do you parents own guns? Yes ____ No ____
Have your parents shot any of your previous significant others? Yes ____ No ____
Are your parents Hicks, Hillbillies, or Rednecks? Yup ____ No____
Do you have any other relationships currently? Yes ____ No ____
How many? ________
Do I know any of them? Yes ____ No ____
Who? _______________________________
Do you have any ex's that will threaten my life for dating you? Yes ____ No ____
Who? _________________________
What interests do you have that I don't know about? _____________________________________
What wierd quirks and flaws do you have?_____________________________________________
In 500 words or less, describe why YOU deserve me and why I should pick you to be my boyfriend.
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Signature: _______________________________________
Social Security Number: ____________________________
Mother's Maiden Name: ____________________________
Thank you for filling out this application, please return it to the e-mail address or mailing address I have given to you. If you fail to recieve any response, try again, if there is still no response that means that I have given you a fake address and don't want you so DEAL WITH IT!
Please E-Mail Completed Applications to sariannrogers@yahoo.com