| Note: | This application will be incomplete and rejected unless accompanied by a complete financial statement, job history, lineage, and current medical report from your physician. | ||||||||||||||||||||||||||||||||||
| What is your name, age, social security number, IQ and Boy Scout rank? | |||||||||||||||||||||||||||||||||||
| Do you have one male and one female parent? | Yes No | ||||||||||||||||||||||||||||||||||
| If no, please explain. | |||||||||||||||||||||||||||||||||||
| Do you own or have access to a van? | Yes No | ||||||||||||||||||||||||||||||||||
| A truck with oversize tires? | Yes No | ||||||||||||||||||||||||||||||||||
| A waterbed? | Yes No | ||||||||||||||||||||||||||||||||||
| Do you have an earring, nose ring, or belly button ring? | Yes No | ||||||||||||||||||||||||||||||||||
| Do you have a tattoo? | Yes No |
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| *If you answered YES to #4, #5 or #6, discontinue application and leave immediately* |
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| In fifty words or less, what does LATE mean to you? | |||||||||||||||||||||||||||||||||||
| In fifty words or less, what does DON'T TOUCH MY DAUGHTER mean to you? | |||||||||||||||||||||||||||||||||||
| In fifty words or less, what does ABSTINENCE mean to you? | |||||||||||||||||||||||||||||||||||
| In fifty words or less, what does EXCRUCIATING PAIN mean to you? | |||||||||||||||||||||||||||||||||||
| Church/Temple you attend | |||||||||||||||||||||||||||||||||||
| How often do you attend? |
| When is the best time to interview your mother, father and priest / rabbi? |
| Please fill in the blanks, be complete and truthful. Attach additional pages as necessary.
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If I were shot, the last place on my body I would want wounded would be: |
| If I were beaten, the last bone I would want broken would be: |
| A woman's place is in the: |
| The one thing I hope this application doesn't ask is: |
| When I meet a girl, the one thing I always notice about her first is: |
| *Note: If answer to last question is not "her eyes", discontinue and leave premises - keeping your head low
and running in a serpentine fashion is advised*
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What do you want to be *IF* you grow up? |
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I swear that all the above information is correct to the best of my knowledge under penalty of death, bodily harm, dismemberment, torture and mental abuse.
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Signature of applicant |
____________________________________________________
| Signature of father |
____________________________________________________
| Signature of mother |
____________________________________________________
| Signature of priest/rabbi |
____________________________________________________
| Signature of State Representative |
____________________________________________________
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| Thank you for your interest, and it had better be genuine. Please allow 4-6 years for processing. You will be contacted in writing if approved. If denied, never apply again. Don't call me, I'll call you. |