Note: This application will be incomplete and rejected unless accompanied by a complete financial statement, school history, job history, ancestral lineage, DMV printout, and a current medical report from your doctor.

Name _____________________Date of Birth _____________

Height ______Weight______IQ_______GPA ____________

Social Security # _________Driver's 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:

An earring, nose ring, or a belly button ring? ___

A tattoo? ___

(If yes to any of the above, discontinue application and leave 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? _____________

Parole officer? _______

Answer by filling in the blank. Please answer freely, all answers are confidential.

A: If I were shot, the last place I would want to be 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 application. 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

How do you know? ______________________________________________

I swear that all the 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 black shirts and white ties carrying violin cases (you might want to watch your back).

Have a nice day.