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Full Name (first, middle, last) __________________________________
Date of Birth __/___/___ Height_____ Weight_____ IQ_____ GPA______
Social Security #____-____-____ Driver's License #_________________
Boy Scout Rank______________________________________________
Home Address (city, state, zip)__________________________________
_______________________________________________apt. # _______
Do you have one MALE and one FEMALE parent in the home?(y/n)_____
If no, please explain:___________________________________________
____________________________________________________________
Do you own a van?(y/n)____ Truck w/oversized tires?(y/n) _____ Waterbed?(y/n)____
Do you have an earring, nose ring, nipple ring, belly button ring, tattoo?(circle all that apply)
In 50 words or less...what does the word "LATE" mean to you?___________
______________________________________________________________
In at least 25 words...What do the words, " Don't touch my daughter mean to you" ?
_______________________________________________________
________________________________________________________
In at least 25 words...What does the word "ABSTINENCE" mean to you?
_______________________________________________________________
_______________________________________________________________
Feel free to use back of page or attach additional sheets for above questions.
Church you attend:____________________How often?_________________
When would be the best time to interview your father, mother, and priest or other religious education provider?____________________________________________________
_____________________________________________________________
Answer the following freely and completely honestly. All Answers are Confidential (that means I will not tell anyone --ever--really! I promise! )
I. If I were shot, the last place on my body I would want to be wounded is____________________.
2. If I were beaten, the last bone I would want broken is my____________.
3. A woman's place is_______________________________.
4. The "one" thing I hope this application doesn't ask me about is ____________________
_________________________________________________________________________
_________________________________________________________________________.
5. When I meet a girl, the first thing I notice about her is_____________.*
*Note...if the answer to this question begins with T or A Discontinue at this point and leave the premises! Keeping your head low and running in a serpentine fashion is advised.
6. What do you want to be IF you grow up?
I swear that all information supplied above is true and correct to the bestof my knowledge, under penalty of death, a severe beating, dismemberment, torture, crucifixion, electrocution, or a kiss by Hilary Clinton. Any penalty will be decided at the whim of the father.
Signature ________________________________ Date ________
Witness ________________________________ Date ________
Character Reference ________________________________ Date ________
Notarized ________________________________ Date ________
Note: This application will be considered incomplete and rejected unless accompanied by a complete financial statement, copy of birth certificate, job history, lineage, and a current medical report from your doctor.
Please allow four (4) to six (6) years for processing. You will be contacted in writing if you are approved. Do not call or write as this will only delay the procedure and possibly cause you undue anxiety, if not a visit from the terminator. If your application is rejected, you will be notified in person by two well dressed gentlemen with violin cases.
Do not turn your back on them.
Thank you for your interest!
---------and by the way...Have a NICE DAY!-------------
