| NOTE: this
application will be rejected unless accompanied by a complete
financial statement, job history, lineage, and current medical
report from your physician.
1. Full Name: ______________________________ DOB:________________________
2. Height: _________________ Weight: _____________ IQ ________
3. Social Security #: ____________________ Drivers License
4. Boy Scout Rank_____________________ High School Attended
5. Home Address: _____________________ City/State/Zip________________________
6. Do you have one MALE and one FEMALE parent? ______ # of
years married: _____
7. Do you own a van? ________ A truck with oversized tires?
_______ Waterbed? _____
8. In 50 words or less, what does LATE mean to you? ____________________________
9. In 50 words or less, what does DONT TOUCH MY DAUGHTER
mean to you? ____
10. In 50 words or less, what does ABSTINENCE mean to you?
11. Church you attend: ___________________________ How often?
12. When is the best time to interview you mother and father?
13. Answer by filling in the blank. Please answer freely. All
answers are confidential. (That means I wont tell anyone
ever, I promise)
A: If I were shot, the last place on my body I would want
to be wounded is : ____
B. If I were beaten, the last bone I would want broken is
C. A womans place is in the _________________________________________
D. The thing I hope this application does not ask me is:
E. When I first meet a girl, the first thing I notice about
her is: _______________
(NOTE: If answer E begins with T or
A or anything associated with those areas, discontinue
and leave premises, keeping your head low, and run. High speed
14. What do you want to be if you grow up? ____________________________________
15. Do you think disembowelment or emasculation hurts more?
FINE PRINT: I SWEAR THAT ALL THE INFORMATION
SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
I SWEAR UNDER THE PENALTY OF DEATH, NATIVE AMERICAN ANT TORTURE,
ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND THE
MARINE CORPS MONKEY STOMP.
SIGNATURE (that means you, 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
cant and it would cause you great bodily harm). If your
application is rejected, you will be notified by two gentlemen
wearing cammy paint and carry high-powered rifles with a target
scope, hiding in the dense forest or high areas. Once again,