NOTE: This application will be incomplete and rejected unless
accompanied by a complete financial statement, school history, job
history, ancestral lineage, DMV printout, and a 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, please 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?__________

A condom?_______________

Pornography?_______________

Do you have an earring, nose ring, or a belly button ring? ______________

A tattoo?_____________

(IF YES TO ANY OF 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? _____________         priest? _______________

        mother? _____________         parole officer? _______

Answer by filling in the blank.  Please answer freely, all answers
are confidential.


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 do IF you grow up? ______________________________

_____________________________________________________________________


What is the current going rate of a hotel room? _____________________

Condoms come in packages of (circle one)

        A:  3
        B:  6
        C:  9
        D: 12
        E: ALL OF THE ABOVE

How do you know?_____________________________________________________

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 black shirts and white ties carrying violin
cases (you might want to watch your back).

Have a nice day.