1. NAME _______________________________ DATE OF BIRTH ________________

2. HEIGHT ____________________ WEIGHT __________ I.Q _______ G.P.A.______

3. SOCIAL SECURITY # _____________ DRIVERS LICENSE # __________________

4. BOY SCOUT RANK____________________________________________________

5. HOME ADDRESS _________________ CITY/STATE ___________ ZIP _________

6. Do you have one MALE and one FEMALE parent?___________________________
If No., EXPLAIN

___________________________________________________

7. Number of years your parents have been married ____________________________

8. Do you own a van? ______ A truck with oversized tires? ______ A waterbed? _______ Do you have an earring, nose ring, or belly button ring?
A tattoo_________________ (If "yes" to any of #8, discontinue application and leave premises )

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

_______________________________________________________________________

10. In 50 words or lest, 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 do you attend __________________

13. When would be the best time to interview your father, mother and priest/rabbi/minister? __________

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

a) If I were shot the last place on my body I would want wounded is ________

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 first thing I notice about her is her ______________

( NOTE: If your answer begins with "T" or "A", discontinue. 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? __________________________________

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, ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.

________________________________________ Signature ( That means your name, moron)