1. NAME DATE OF BIRTH WEIGHT I.Q G.P.A.
2. SOCIAL SECURITY # DRIVERS LICENSE #
3. BOY SCOUT RANK
4. HOME ADDRESS CITY/STATE ZIP
5. Do you have one MALE and one FEMALE parent? Yes No
   If No., EXPLAIN
6. Number of years your parents have been married
7. Do you own a van? Yes No
   A truck with oversized tires? Yes No
   A waterbed? Yes No
   Do you have an earring, nose ring, or belly button ring? Yes No
   A tattoo Yes No
   (If "yes" to any of #8, discontinue application and leave premises )
8. In 50 words or less, what does "LATE" mean to you?
   
9. In 50 words or lest, 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.)
    1. If I were shot the last place on my body I would want wounded is
       
    2. If I were beaten, the last bone I would want broken is my
       
    3. A woman's place is in the
       
    4. The one thing I hope this application does not ask me about is
       
    5. 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?

Thank you for your interest Please allow four to six years for processing. You will be notified in writing you are approved. Please do not try to call or write (since you probably can't and it would cause you injury.) if your application is rejected, you will be notified by two gentlemen weaning white ties and carrying violin cases (You might want to watch your back)