NAME _____________________________ DATE OF BIRTH ____________
HEIGHT ________ WEIGHT _________ IQ __________ GPA _________
SOCIAL SECURITY #______________ DRIVERS LICENSE #____________
BOY SCOUT RANK AND BADGES________________________________________
CITY/STATE ____________________________ ZIP______
Do you have parents? ___Yes ___No Is one male and the other female? ___Yes ___No If No, explain: _______________________________________________________ ___________________________________________________________________
Number of years they have been married _________________________________
If less than your age, explain: ____________________________________________________________________ ____________________________________________________________________
A. Do you own or have access to a van? __Yes __No
B. A truck with oversized tires? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
F. Do you have an earring, nose ring, __Yes __No pierced tongue, pierced cheek or a belly button ring?
(IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
In 50 words or less, what does 'LATE' mean to you? ____________________________________________________________________ ____________________________________________________________________
In 50 words or less, what does 'DON'T TOUCH MY SISTER' mean to you? ____________________________________________________________________ ____________________________________________________________________
In 50 words or less, what does 'ABSTINENCE' mean to you? ____________________________________________________________________ ____________________________________________________________________
Church you attend ___________________________________________________
How often you attend ________________________________________________
When would be the best time to interview your:
Answer by filling in the blank. Please answer freely, all answers are confidential.
A: If I were shot, the last place I would want shot would be:
G. What is the current going rate of a hotel room? __________________________
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANTI TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
__________________________________________________________________ Applicant's Signature (that means sign your name, moron!)
_______________________________ ________________________________ Pastor/Priest/ Rabbi State Representative/Congressman
Thank you for your interest, and it had better be genuine and non-sexual. Please allow four to six years for processing.
You will be contacted in writing if 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 carrying violin cases (you might want to watch your back) .