APPLICATION TO DATE MY CHILDREN
PARENTS: Kevin & Deb Hentges
Name: (Last)__________________________First:____________________MI_______
Address:_______________________________________________County:___________
Religion:__________________________#of attendances last year?_________________
Parents: Father Name_______________________#of marriages________Years_______
Fathers Address_________________________________Phone #___________________
Mothers Name_______________________#of marriages________Years_______
Mothers Address________________________________Phone#____________________
- Do you drive a van? (If yes, discontinue filling out form. Good-Bye)
- In 50 words or less describe what NO means to you.___________________________
________________________________________________________________________
________________________________________________________________________
- In 50 words or less describe what LATE means to you________________________
________________________________________________________________________
- What hospital do you prefer for a DNA & Blood Test?_________________________
- Which is the last bone you want broken?___________________________
- Have you ever been shot before?__________________________________
- What do you want to be if you grow up?_________________________
- Do you have life insurance?_________________Amount?___________________
- The place for a woman is……____________________________________________
- What is my daughters name?_________________________________
- Who besides God should you fear most?____________________________
- Drivers License number_______________________#of points left on License______
13. Do you have a will?________________________Name of beneficiary_______________
Parental use only:
Appearance: Most looks like: Circle one STATUS:
- Barney Fife Call Police Now
- Sponge Bob Accepted
- David Letterman Rejected
- Pee-Wee Herman Pending
- Al Gore Call Hit-Man