DATE OF BIRTH___/___/___

2.HEIGHT__________________WEIGHT___________IQ______GPA_______

3. SOCIAL SECURITY#______________DRIVERS LIC#_______________

4. BOY SCOUT RANK___________________________

5. HOME ADDRESS______________CITY/STATE_______________ZIP_______

6. DO YOU HAVE ONE MALE AND ONE FEMALE PARENT?_______________
IF NO, PLEASE EXPLAIN___________________________________

7. NUMBER OF YEARS PARENTS MARRIED?____________________

8. DO YOU OWN A VAN?________________MOTORCYCLE?______________
TRUCK WITH OVERSIZED TIRES?___________WATERBED?____________
DO YOU HAVE AN EARRING?____NOSE RING?____BELLY BUTTON RING__

9. IN 50 WORDS OR LESS, WHAT DOES DON'T TOUCH MY DAUGHTER MEANS TO YOU?__________________________________________________

10. IN 50 WORDS OR LESS, WHAT DOES LATE MEAN TO YOU?________________________________________________________

11. IN 50 WORDS OR LESS, WHAT DOES ABSTINENCE MEAN TO YOU?__________________________________________

12. CHURCH YOU ATTEND?________________________

13. WHEN WOULD BE THE BEST TIME TO INTERVIEW YOUR FATHER?_________MOTHER?___________PRIEST?__________

14. ANSWER BY FILLING IN THE BLANK. PLEASE ANSWER FREELY, ALL ANSWERS ARE CONFIDENTIAL (THAT MEANS I WON'T TELL ANYONE)
A. IF I WERE SHOT, THE LAST PLACE ON MY BODY I WOULD WANT WOUNDED IS THE ________________
B. IF I WERE BEATEN, THE LAST PLACE I WOULD WANT BROKEN IS MY _____________
C. A WOMAN'S PLACE IS IN THE ______________
D.. THE ONE THING I HOPE THIS APPLICATION DOESN'T ASK IS _________
E. WHEN I FIRST MEET A GIRL, THE THING I NOTICE FIRST IS HER ________
(NOTE: IF THE ANSWERS STARTS WITH A T OR AN A, DISCONTINUE APPLICATION AND LEAVE PREMISES, KEEPING LOW AND RUNNING IN A SERPENTINE FASHION IS ADVISED.)

15. WHAT DO YOU WANT TO BE IF YOU GROW UP?________________

I SWEAR THAT ALL OF THE INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICA AN TORTURE, CRUCIFIXION,ELECTROCUTION, CHINESE WATER TORTURE, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.

_________________________________
SIGNATURE (THAT MEANS YOU SIGN YOUR NAME)

THANK YOU FOR YOUR INTEREST. PLEASE ALLOW FOUR TO SIX YEARS FOR PROCESSING. YOU WILL BE NOTIFIED IN WRITING IF YOU ARE APPROVED. PLEASE DO NOT CALL OR WRITE (AS IT WILL CAUSE YOU INJURY)