Note: This application will be incomplete and rejected
unless accompanied by a complete
financial statement, job history, lineage, and
current medical report from your physician.
| 1. |
What is your name, age, social security number, IQ and boy scout
rank?
_______________________________________________________________________________________________
|
| 2. |
Do you have one male and one female parent?
_________ If "No", explain:
_______________________________________________________________________________________________
|
| 3. |
Do you own or have access to a van? _________ A truck with oversize tires? _________ A waterbed? _________
|
| 4. |
Do you have an earring, nose ring, or belly button ring?
_________
|
| 5. |
Do you have a tattoo?
_________
*If you have answered YES to #3, #4 or #5, discontinue application and leave immediately.
|
| 6. |
In fifty words or less, what does LATE mean to you? _______________________________________________________________________________________________ _______________________________________________________________________________________________
|
| 7. |
In fifty words or less, what does DON'T TOUCH MY DAUGHTER mean to
you?
_______________________________________________________________________________________________ _______________________________________________________________________________________________
|
| 8. |
In fifty words or less, what does ABSTINENCE mean to you?
_______________________________________________________________________________________________ _______________________________________________________________________________________________
|
| 9. |
In fifty words or less, what does REAL PAIN mean to you?
_______________________________________________________________________________________________ _______________________________________________________________________________________________
|
| 10. |
Church/Temple you attend: _____________________
|
| 11. |
How often do you attend: _____________________
|
| 12. |
When would be the best time to interview your mother, father and
priest/rabbi?
_______________________________________________________________________________________________
|
| 13. |
Please fill in the blanks: If I were shot, the last place on my body I would want wounded would be my: ___________________If I were beaten, the last bone I would want broken would be my: ______________________________ A woman's place is in the: ____________________________________________________________________ The one thing I hope this application doesn't ask is: _________________________________________ When I meet a girl, the one thing I always notice about her first is: _________________________
*Note: If answer to last question begins with
"T" or "A", discontinue and leave premises.
|
| 14. |
What do you want to be IF you grow up? _______________________________________________________________________________________________
|
|
I swear that all the above information is correct to the best of my
knowledge under penalty of death, bodily harm, dismemberment, torture or mental abuse.
|
|
|
Signature of applicant
___________________________________________________________
Signature of father ______________________________________________________________ Signature of mother ______________________________________________________________ Signature of priest/rabbi ________________________________________________________ Signature of State Representative ________________________________________________
|
|
|
Thank you for your interest, and it had better be genuine and
non-sexual. |
|