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 CODE ___________________
6. Do you have one MALE and one FEMALE parent? ____________
If not., EXPLAIN ___________________________________________
7. Number of years your parents have been married _____________
8. Do you own a van? _________ A truck with oversize tires? ________
A waterbed? _______
Do you have an earring, nose ring, or belly button ring? ________
(If "yes" to any of # 8, dicontinue application and leave premises)
9. In 50 words or less, what does "LATE" mean to you? __________________________________________________ ___
__________________________________________________ ___
10. In 50 words or less, 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 _________
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 her ____________
(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 and RED HOT POKERS.
_________________________________________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 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 and carrying violin cases. (You might want to watch your back)