Note: This
application will be considered incomplete and therefore rejected unless
accompanied by a complete financial statement, job history, lineage, and
medical report from your doctor.
Name:____________________ Nickname/Alias:_______________
Date of
Birth:____/____/____ Height:_______ Weight:_______
I.Q.:_____
G.P.A.:_____ Social Security #:______-______-______
Driver's License
#:_______________
Boy Scout Rank:__________ Good Standing: Yes_____
No_____
Home Address:____________________
City, State,
Zip:____________________ Home Phone #:__________
Car Phone #:__________
Pager:__________
Do you own:
A. Van_____
B. Truck with oversized tires_____
C.
Car with trunk full of speakers_____
Do you have any of the following:
A. Earring_____
B. Nose
ring_____
C. Navel ring_____
D. Piercings on any other body
parts_____
If yes, explain:______________________________
E.
Tatoo_____
If you answered YES to any of the above questions, discontinue
application and leave the premises immediately!
In 30 words or less, what does "LATE" mean to
you?_________________________________________________________
_________________________.
In 30 words or less, what does "DON'T TOUCH MY DAUGHTER" mean to
you?_________________________________________________________
_________________________.
Church you attend:____________________
How
often:_______________
Best time to interview pastor:_______________
Fill in the blanks. Please answer freely. All answers will be
confidential.
A. If I were beaten, the last bone I would want
broken would be:
_______________.
B. The one thing I hope this
application does not ask me
is:
________________________________________.
C. Now answer the
question you filled in on B.:
_________________________.
NOTE: If you answered any of the previous questions dishonestly (and
I will find out), discontinue application. It is advised that you leave
the premises quickly keeping your head low and running in serpentine
fashion.
I swear that all information provided above is true to the best of my
knowledge under penalty of death, dismemberment, electrocution, and/or hot
pokers.
______________________________
Signature (this means sign your
name)
Thank you for your interest. Please allow 4-6 YEARS for processing. If
your application is approved, you will be contacted in writing. Please do
not call or write; this could cause you unexpected injury.
If your application is rejected, you will be notified by two men
wearing white ties and answering to the names of GUIDO and LOUIE.