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.
