| APPLICATION TO START A RELATIONSHIP | ||||
| Name: | ||||
| Age: | ||||
| Address: | ||||
| City, State, Zip: | ||||
| Social Security Number: | ||||
| Blood Type: | ||||
| Driver's License No.: | ||||
| Phone No: | ||||
| If I call this phone number right now and ask to speak with you, will the person on the other end of the line know who I'm asking for? | yes | no | ||
| Do you think a man or a woman is responsible for protection? (If he says he will bring his own gun, he hasn't a clue. Move on to next candidate.) | answer: | |||
| If neither of us has protection, will you suggest "other ways to have fun" or will you accept the fact that there is no way any fun will be had tonight? | answer: | |||
| Will you accept it if I don't reach orgasm or will you attempt to drive me to the point of pain to prove your "manhood"? | answer: | |||
| Do you know what I mean when I say, "Let's just be friends?" | yes | no | ||
| What do you consider 'cheating'? (Any answer other than "I would never do that" is unacceptable because it means he has thought about pushing the boundaries.) | answer: | |||
| Do you have a strange attachment to your mother? (If her calls her 'Mommy' and still wears Underoos, move on to next candidate.) | yes | no | ||
| Do you believe a woman should be barefoot and pregnant? | yes | no | ||
| If I happen to call you two months from now, will you remember who I am? | yes | no | ||
| If I tell you I'm pregnant during that conversation, will you still remember who I am? | yes | no | ||
| If I discover I'm pregnant, will you deny that a relationship ever occurred between us? | yes | no | ||
| Will you insist that you could not possibly be the father because we used protection, I cheated on you, etc.? | yes | no | ||
| If I decide to make an adoption plan for this child, will you support my decision? | yes | no | ||
| Will you make yourself available to the child whenever necessary for answers to questions, current medical information, etc.? | yes | no | ||
| If you refuse to make yourself available to this child and he/she comes searching for you in 20 years, will you admit to being his/her father, or will you slam the door in his/her face? | answer: | |||
| Will you tell your family you fathered a child or will you hide it from them as if the child is a "dirty little secret"? | answer: | |||
| Please list your medical history, including any conditions your parents, grandparents, aunts and uncles on both sides of your family have been diagnosed with. (Attach separate sheet as necessary.) | answer: | |||
| Will you agree to submit to a background check? (Any answer other than 'yes' will immediately disqualify you as a candidate for relationship.) | yes | no | ||
Signature: | ||||
| Date: | ||||
| Please ask for inkpad to complete this portion of the application. | ||||
| LEFT THUMB | LEFT INDEX | LEFT MIDDLE | LEFT RING | LEFT PINKY |
| RIGHT THUMB | RIGHT INDEX | RIGHT MIDDLE | RIGHT RING | RIGHT PINKY |
| Please make fingerprints clear as they will be checked against AFIS system at the Police Department. | ||||
| Thank you for your interest in pursuing a relationship with me. You will be contacted as soon as your application is approved. Please do not call me. I will call you! | ||||
© Gina & Andrea
| Adoption Profiles |
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