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

1. NAME_______________________________ DATE OF BIRTH____________

2. HEIGHT:__________ WEIGHT:__________ I.Q. _________ G.P.A._________

3. SOCIAL SECURITY#_________________ DRIVER'S LICENSE # __________

4. BOY SCOUT RANK ____________________________________________

5. HOME ADDRESS___________________ CITY/STATE_______ ZIP_____

6. Do you have one MALE and one FEMALE parent?_________________

7. Number of years parents married: ______________

8. Do you own a van?_____ A truck with oversized tires?____ A waterbed?______

9. In 50 words or less, what does LATE mean to you?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

10. In 50 words or less, what does DON'T TOUCH MY DAUGHTER mean to you?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

11. In 50 words or less, what does ABSTINENCE mean to you?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

12. Church you attend? ________________________ How often? ___________

13. When would be the best time to interview your father, mother, and priest? ______

14. Answer by filling in the blank: please answer freely - all answers are confidential (That means I won't tell anyone-ever-promise).

  A. If I were shot, the last place on my body I would want to be wounded is ________
  B. If I were beaten, the last bone I would want broken is _____________
  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 a T or A, discontinue and leave premises; keeping your head 
   low and running in a serpentine fashion is advised).

15. What do you want to be IF you grow up? __________________

16. Do you have any holes in your body other than the ones God graced you with and if so, how many? _______________

I SWEAR THAT ALL 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)