Name _____________________ Date of birth ______________
Height/weight_______/_______ IQ _______ Social Security Number _____________
Driver's License # _________________ Boy Scout rank _____________
Home address ____________________________________
City/State/Zip Code___________________________________
Do you have one MALE and one FEMALE parent? _____
If no, explain_____________________________________
_______________________________________________
Number of years parents married? ________________
Do you own:
A van? ____________
A truck with oversized tires?____________
A waterbed?____________
Do you have:
An earring, nose ring, belly button ring, or any other body piercing? ____________
Tattoo? ____________
Motorcycle? ____________
(IF YOU ANSWERED "YES" TO ANY OF THE LAST 6 QUESTIONS, DISCONTINUE APPLICATION AND LEAVE QUICKLY!)
In 25 words or less, explain what LATE means to you:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
In 25 words or less, explain what DON'T TOUCH MY DAUGHTER means to you:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
In 25 words or less, explain what ABSTINENCE means to you:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Church you attend ____________________________
How often do you attend? __________________________
When would be the best time to interview your father, mother, and minister?
_______________________________
a. If I were shot, the last place on my body I would want to be wounded is in the __________________________
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 the most is __________________________________________
What do you want to be IF you grow up?: __________________________________________
I PROMISE THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF NATIVE AMERICAN ANT TORTURE, RED HOT POKERS, CHINESE WATER TORTURE, DISMEMBERMENT, DEATH, AND HILLARY CLINTON KISS TORTURE.
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Signature (That means you sign your name, moron!)