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 own or have access to a van? ____ 3. A truck with oversize tires? ____ 4. waterbed? ____ 5. Do you have an earring, nose ring, or belly button ring? ____ 6. Do you have a tattoo? ____ *If you have answered YES to #3, #4 or #5, discontinue application and leave immediately.* 7. In fifty words or less, what does LATE mean to you? 8. In fifty words or less, what does DON'T TOUCH MY DAUGHTER mean to you? 9. In fifty words or less, what does ABSTINENCE mean to you? 10. In fifty words or less, what does REAL PAIN mean to you? 11. Church/Temple you attend: ____________________________ 12. How often do you attend: ____________________________ 13. When would be the best time to interview your mother, father and priest/rabbi? ____________________________ 14. Please fill in the blanks: If I were shot, the last place on my body I would want wounded would be _____________________ If I were beaten, the last bone I would want broken would be _____________________ The one thing I hope this application doesn't ask is _____________________ 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 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.