dating application 2006

perhaps if we single folks took the time to get to know each other and ask those important questions up front, there would be a better sucess rate in long-term relationships and marriages. the following "dating application" was forwarded to me by some friends. it is funny, but i don't see why they couldn't be adapted for real dating world use:

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for the girls
Dating Application

Name
First________________ Middle _____________ Last_____________
Address _______________________________________
City _________________________ State _____ Zip ___________
Home # ______________________________ Cell#______________

Do you live with any of the following: (circle)
Grandmother
Parents
Mother
Father
Girlfriend
Baby Mama
Alone
Shelter
Wife
Auntie
Other: _________________


Weight _______ Height ________

Ethnicity:
Black
Hispanic
White
Other:_________________

D.O.B. ______ Age ____ SS# _____-___-_________

Any children (Circle one) yes no

If yes, how many _______

How many baby mamas? _________

If more than one, please name below.

Use separate sheet of paper if need more room.

1. _______________________________________
2. _______________________________________
3. _______________________________________

Do you owe child support? (Circle one) Yes No Don't Know

*If your ex is getting state benefits (childcare, food stamps, etc), then you owe somebody something. Especially tax payers. Stop here and go take care of your dang kids.)

Ever been married (circle) yes no
If yes, how many times? _______

Are you or have you ever been on the Down Low? (Circle one) yes no

*Please use a separate sheet of paper and list goals and accomplishments.


Did you graduate from high school? (circle one) yes no

Name/address of high school:__________________________

Have you received any of the following? (Circle one)
GED Diploma

*If you did not complete any of the above, please stop here and return to school.

Any college? (circle one) yes no still enrolled graduated

Name/address of college (copy od transcripts required): _____________

Have you ever been to prison or convicted of a crime? (Circle one) yes no

If yes, reason? (be very specific)

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________


*If you have answered yes to the above question, please STOP HERE and call your P.O. immediately.

Employed? (Circle one) yes no
*If no, please stop here.

If yes, where and how long?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Do you have health insurance? (Circle one) Yes No

When did you last visit the dentist? ____________________

When was your last doctor visit?_____________________

Reason: ____________________________________________ ____________________________________________________
__________________________________________________

List any (all) illnesses. Use separate sheet of paper if needed.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Do you have or have you had any of the following?
(Circle all that may apply)

Hepetitis A B or C
Herpes
Mononucleosis
HIV/AIDS
The Bird Flu
West Nile Virus
Crabs
Chlamydia
Gonorrhea
SARS
Head Lice
Ringworms
Boils
Shingles
Something that you can't spell
Meningitis
Measles
Mumps
Ebola Virus
Bunions

*If you have circled any of these, DO NOT turn in your application.

Do you or have you ever used (ingested in any way) any of the following:
(Circle all that apply)

Crack/Cocaine
Heroin
Paint
Markers
Ecstasy
Glue
Bad pills
Snuff anything under the kitchen sink


*If you have circled any of these, DO NOT turn in your application.

By signing below, you agree that all of the information given above is true to the best of your knowledge. For my protection, you will be asked to provide the following information upon request: state ID, birth certificate, recent payroll stub, a recent clean bill of health from a certified physician or practitioner.

Falsifying information may result in termination of this relationship (if applicable), and a severe a** whooping by my project cousins Pookie, Ray-Ray, Darnell, Lil Krazy or all of the above.

Applicant Signature________________________

Print Name_________________________________

Date _______________________