NOTE: This application will be incomplete and rejected unless accompanied by a complete financial statement, job history, linage and current medical report from your doctor. Please be prepared to submit additional information (like psychological profile and polygraph test) as required.

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Name:___________________________Date of Birth:______________________
Height:____________ Weight:____________ I.Q.___________ GPA:_________
Social Security Number:___________________ Driver's License #:____________
Boy Scout Rank:___________________________________________________
Home Address:____________________________ City:____________________
State:____________________________ Zip Code:_______________________

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How fast can you run: 40 yards?_______________ 2 miles?___________________
Do you own a? A)Van____ B)Truck with oversized tires?_____ C)Waterbed?_____
Do you have an earring, nose ring or belly button ring?__________ Tatoo?_________
NOTE: If you answered YES to any part of questions #8, discontinue the application process and leave the 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 do you attend?_________
___ When would be the best time to interview your father, mother and minister?_________
Answer by filling in the blanks. Please answer freely. All answers are confidential.
(That means I won't tell anyone, ever)

If I were shot, the last place on my body I would want to be wounded is the__________.
If I were beaten, the last bone I would want broken is___________________________.
A Women's place is in the _________________________.
The one thing I hope this application does not ask me about is__________________.
In the unfortunate event of my untimely death, I would like______________to be contacted.
My greatest fear is__________________________________________.
When I first meet a girl, the first thing I notice about her is her___________________.
NOTE: If the answer to the last question begins with a "B", discontinue the application process and leave the premises.
Keep your head low and running in a serpentine fashion is advised.

What do you want to be "IF" you grow up?____________________________
Have you ever been fingerprinted?______ Had a DNA sample taken and recorded?_________
Your dentist is__________________ Emergency phone #_________________________

I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT,
UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, ELECTROCUTION, CHINESE WATER TORTURE AND/OR HOT POKERS.

Signature________________________

Thank you for your interest. Please allow 4-6 years for processing.
You will be contacted in writing if you are approved.
Please do not try to call or write.
(It could cause disqualification and injury to your body.)

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