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? __

  4. A truck with oversize tires? __

  5. waterbed? __

  6. Do you have an earring, nose ring, or belly button ring? __

  7. Do you have a tattoo? __

If you have answered YES to #3, #4 or #5, discontinue application and leave immediately.

  1. In fifty words or less, what does LATE mean to you?

  2. In fifty words or less, what does DON’T TOUCH MY DAUGHTER mean to you?

  3. In fifty words or less, what does ABSTINENCE mean to you?

  4. In fifty words or less, what does REAL PAIN mean to you?

  5. Church/Temple you attend: __________

  6. How often do you attend: __________

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

  8. 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 — keeping your head low and running in a serpentine fashion is advised

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. Please allow 4-6 years for processing. You will be contacted in writing if approved. If denied, please never apply again. Don’t call me, I’ll call you.