(NOTE: This application will be incomplete and rejected unless accompanied by a complete financial statement, school history, job history, ancestral lineage, DMV printout, and a current medical report from your doctor.)
NAME____________________________________
DATE OF BIRTH______________
HEIGHT___________
WEIGHT_____________
IQ__________
GPA_____________
SOCIAL SECURITY #__________________
DRIVERS LICENSE #________________
BOY SCOUT RANK AND BADGES_____________________________________
HOME ADDRESS_________________________
CITY/STATE___________
ZIP_____
Do you have ONE male and ONE female parent
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If NO, please explain
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Number of years they have been married
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If less than your age, explain
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Do you own a van? ____________
A truck with oversized tires?___________
A waterbed?____________
A pickup with a mattress in the back?__________
A condom?_______________
Pornography?_______________
A tattoo?_____________
(IF YES TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES)
In 50 words or less, what does LATE mean to you?
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In 50 words or less, what does DON'T TOUCH MY DAUGHTER, mean to you?
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In 50 words or less, what does ABSTINENCE mean to you?
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Church you attend
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How often you attend
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When would be the best time to interview your:
father? _____________
clergyman? _______________
mother? _____________
parole officer? __________
Answer by filling in the blank. Please answer freely, all answers are confidential.
C: A woman's place is in the:___________________________________
D: The one thing I hope this application does not ask me about is:
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E: When I first meet a girl, the thing I notice about her first is:
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(NOTE: if answer E begins with T or A, discontinue. Leaving premises keeping your head low and running in a serpentine fashion is advised.)
What do you want to do IF you grow up? _________________________
What is the current going rate of a hotel room? _____________________
Condoms come in packages of (circle one) 3 6 9 12 ALL OF THE ABOVE
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE & RED HOT POKERS.
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Thank you for your interest. Please allow four to six years for processing. Have a nice day.
*~*Feel free to leave*~*