Application For Permission To Date My Daughter

Note: Form is to be completed at least 21 days prior to date

Personal Details

NAME:

ADDRESS:

EMAIL:

PHONE NUMBER:

IQ:

Gender

Male

Female

Other

Date of Proposed Quting:

Check All That Apply

I have tattoos and/or piercings

I am more than 2 years older than my daughter

I own a panel van or V8 ute

I work full-time

My parents are rich

Is the date at a well lit public location

Political Persuasion: Education Level Completed:

Essay Section

In 50 words or more explain why you want to date my daughter

Please upload contact details for 2 references

Upload Police Clearance Certificate, Bank Statement and Medical Certifiates here: