NOTE: THis application will be incomplete and rejected unless accompanied by a complete finacial statement, job history, lineage, and current medical report from your doctor. Please be prepared to submit additional information (like a psycological profile and polygraph test) as requested.

1. Name:______________________________________ Date of Birth:_________________________________
2. Height:_______________ Weight:______________ IQ:_________ GPA:_____________________________
3. Social Security Number:___________________________Driver's Licence Number:_________________
4. Boy Scout Rank:____________________________________________________________________________
5. Home Address:__________________________________City/State:________________Zip:_____________
6. How fast do you drive?____________If over 25mph please explain:____________________________
7. Do you wear your seat belt at all times?______ If no please explain:_______________________
8. How fast can you run 40 yards?_______________ How fast can you run 2 miles?________________
9. Do you own a van?_______A truck with big tires?___________ A waterbed?_____________________
   Do you have a earring, nose ring, or belly-button ring?_______________Tattoo?____________________
   (If you answerd YES to any of #9, DISCONTINUE application and leave premises.)
10. In 50 words or less, What does LATE mean to you?___________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________
11. In 50 words or less, What does DONT TOUCH MY DAUGHTER mean to you?_________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________
12. In 50 words or less, What does ABSTINENCE mean to you?_____________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________
13. What Church do you attend?_________________________________How often?______________________
14. When would be the best time to interview your father, mother, and priest?__________________
15. Answer by filling in the blank. Please answer freely; all answers are confidential: If I were shot, the last place on my body I would want to be wounded is the____________________
    If I were beaten, the last bone i would want broken is my______________________________________
    A woman's place is in the _____________________________________________________________________
    The one thing I hope this application does not ask about me is ________________________________
    My greatest fear is ___________________________________________________________________________
    In the unfortunate event of my untimely death I would like my ashes scatterd___________________
    When I first meet a girl, the thing I notice about her is _____________________________________
    NOTE: If the above answer begins with T or A discontinue and leave premises (keeping head low and running in a serpintine fashion is advised)
    
16. What do you want to be IF you grow up?_____________________________________________________
    
17. Have you ever been finger printed?____________DNA sample taken and recorded?_______________
    
18. My dentist is _____________________________________________________________________________
    

____________________________________________

Signature (that means sign your name, moron!)

Thank you for you interest. Please allow four (4) to six (6) years for processing. You will be contacted in writing if you are approved. Please do not try to call or write (since you probably can't and it would cause you injury).