NOTE:This application will be incomplete and rejected unless accompanied by a complete financial statement, job history, lineage, and 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 earring, nose ring, or a belly button ring? _______________ A tattoo? _______________ (IF YES TO THE ABOVE, DISCONTINUE APPLICATION 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 you attend ___________________________________________________ When would be the best time to interview your: father? _____________ mother? _____________ priest? _____________ 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 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 white ties carrying violin cases (you might watch your back).