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 ONE male and ONE female parent?__________ If NO,
explain
________________________________________________________________
Number of years 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?____ A condom?____
Pornography?__
Do you have earring, nose ring, or a belly button 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, and
priest?_______________________________________________________________
Answer by filling in the blank. Please answer freely, all answers
are confidential (that means I won't tell anyone EVER).
A: If I were shot, the last place I would want shot would
be______________
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 thing I notice about her first
is______________
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 be IF you grow
up________________________________
What is the current going rate of a hotel
room?__________________________
Condoms come in A: 3 B: 6 C: 9 D: 12 E: ALL OF THE ABOVE (circle one)
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, 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 gentlemen wearing white ties carrying violin cases (you might want to watch your back).