NOTE: This application will be incomplete and rejected unless accompanied by a complete financial statement job history, lineage, and current medical report from your doctor. 1. NAME _______________________________ DATE OF BIRTH ________________ 2. HEIGHT ____________________ WEIGHT __________ I.Q _______ G.P.A.______ 3. SOCIAL SECURITY # _____________ DRIVERS LICENSE # __________________ 4. BOY SCOUT RANK____________________________________________________ 5. HOME ADDRESS _________________ CITY/STATE ___________ ZIP _________ 6. Do you have one MALE and one FEMALE parent?___________________________ If No., EXPLAIN ___________________________________________________ 7. Number of years your parents have been married ____________________________ 8. Do you own a van? ______ A truck with oversized tires? ______ A waterbed? _______ Do you have an earring, nose ring, or belly button ring? A tattoo_________________ (If yes to any of #8, discontinue application and leave premises ) 9. In 50 words or less, what does LATE mean to you?____________________ _______________________________________________________________________ 10. In 50 words or lest, what does DON'T TOUCH MY DAUGHTER mean to you? _________________________________________________________________________ _______________________________________________________________________ 11. In 50 words or less, what does 'ABSTINENCE mean to you? _____________________________________________________________________ 12. Church you attend _____________ How often do you attend __________________ 13. When would be the best time to interview your father, mother and priest/rabbi/minister? __________ 14. Answer by filling in the blank: please answer freely. ALL answers are confidential (That means I won't tell anyone-ever-I promise.) a) If I were shot the last place on my body I would want wounded is ________ b) If I were beaten, the last bone I would want broken is my ________________ c) A woman's place is in the ________________________________________ d) The one thing I hope this application does not ask me about is _____________ e) When I first meet a girl, the first thing I notice about her Is ( NOTE: If your answer begins with T or A, discontinue. Leave premises keeping your head low and running in a serpentine fashion is advised.) 15. What do you want to be IF you grow up? __________________________________ I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE. ________________________________________ Signature( That means your name, moron) Thank you for your interest Please allow four to six years for processing. You will be notified in writing you are approved. Please do not try to call or write (since you probably can't and it would cause you injury.) if your application is rejected, you will be notified by two gentlemen wearing white ties and carrying violin cases (You might want to watch your back)
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