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 # _____________ 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. 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 #7, discontinue application and leave premises) 8. In 50 words or less, what does "LATE" mean to you?__________________ _______________________________________________________________________ 9. In 50 words or less, what does "DON'T TOUCH MY DAUGHTER" mean to you? _______________________________________________________________________ _______________________________________________________________________ 10. In 50 words or less, what does “ABSTINENCE" mean to you? _______________________________________________________________________ 11. Church you attend __________ How often do you attend ______________ 12. When would be the best time to interview your father, mother and priest/rabbi/minister? __________ 13. 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 (NOTE: If your answer begins with "T" or "A", discontinue. Leave premises keeping your head low and running in a serpentine fashion is advised.) 14. What do you want to be IF you grow up? __________________________________ Signature( That means your name, moron) Thank you for your interest Please allow four to six years for processing. Sincerely,
Larry (The Shabby Shelby Shadow) McCarty | 