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 parents? ___Yes ___No
Is one male and the other female? ___Yes ___No
If No, explain: _____________________________________________________________
_____________________________________________________________________

Number of years they have been married ______________________________

If less than your age, explain
____________________________________________________________________

____________________________________________________________________

ACCESSORIES SECTION:

A. Do you own or have access to a van? __Yes __No

B. A truck with oversized tires? __Yes __No

C. A waterbed? __Yes __No

D. A pickup with a mattress in the back? __Yes __No

E. A tattoo? __Yes __No

F. Do you have an earring, nose ring, pierced tongue,
pierced cheek or a belly button ring? __Yes __No

(IF YOU ANSWERED 'YES' TO ANY OF THE ABOVE, DISCONTINUE APPLICATION AND LEAVE THE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)

ESSAY SECTION:

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?

______________________________________________________________

______________________________________________________________

REFERENCES SECTION:

Church you attend ___________________________________________________

How often you attend ________________________________________________

When would be the best time to interview your:

father? _____________

mother? _____________

pastor? _____________

SHORT-ANSWER SECTION:

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. What do you want to do IF you grow up? ___________________________

______________________________________________________________

______________________________________________________________

F. When I meet a girl, the thing I always notice about her first is:

______________________________________________________________

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, AND RED HOT POKERS.

_________________________________________________________
Applicant's Signature (that means sign your name, moron!)

_______________________________ ________________________________
Mother's Signature Father's Signature

_______________________________ ________________________________
Pastor/Priest/Rabbi State Representative/Congressman

Thank you for your interest, and it had better be genuine and non-sexual.
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.