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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.
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 parents? ___Yes ___No
If No, explain:
_________________________________________________________________________________
Number of years they have been married __________________________________________________
If less than your age, explain ___________________________________________________________
_________________________________________________________________________________
Do you own a van? _______________
A truck with oversized tires? _______________
A waterbed?_______________
A pickup with a mattress in the back?_______________
Do you have an earring, nose ring, or a navel ring? _______________
A tattoo?_______________
(IF YES TO THE ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES)
In 50 words or less, what does LATE mean to you?_________________________________________
________________________________________________________________________________
________________________________________________________________________________
In 50 words or less, what does "DON'T TOUCH MY DAUGHTER" 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:
father? ______________
mother? _____________
pastor? ______________
Answer by filling in the blank. Please answer freely, all answers are confidential.
A: If I were shot, the last place I would want to be shot would be:
________________________________________________________________________________
B: If I were beatern, 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:
________________________________________________________________________________
What do you want to do IF you grow up? ________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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 ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER
TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_____________________________________________
Signature (that means sign your name, moron!)
Thank you for your interest. 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 gentleman wearing white ties carrying violin cases (you might watch your back).
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