Note: This Application must be filled out completely or it will be rejected; it must be accompanied by a complete financial statement, job history, genealogy history; a complete criminal and medical background check must be submitted as required: We reserves the right to have drug screening; psychological profile; or polygraph test performed as we see fit.
MUST BE FILLED OUT COMPLETELY!
NAME___________________________
DATE OF BIRTH____________/___/_________
HEIGHT______ WEIGHT________ I.Q._____ GPA._________
SOCIAL SECURITY #____-______-_____
DRIVERS LICENSE #______-_____-_____
BOY SCOUT RANK __________
HOME ADDRESS__________________________________
CITY / STATE_______________ ZIP__________
HOME PHONE___-_____-_______
WORK PHONE____-_____-_____
PARENT’S ADDRESS IF NOT LIVING AT HOME ________________________
CITY / STATE __________ ZIP____________
THEIR HOME PHONE#____-______-_____
THEIR WORK PHONE#_____-____-_____(FATHER) _____-____-_____(MOTHER)
CHURCH THAT YOU ATTEND NAME____________________________ ADDRESS________________________________________________
CITY / STATE___________________________ ZIP____________
DISQUAIFALICATIONS:
DO YOU OWN:
A VAN ?_______
A TRUCK WITH OVERSIZED TIRES ?______
A FAST CAR ?________
A WATERBED ?_____
DO YOU HAVE EARRING; NOSE RING;BELLY BUTTON RING ?______
TATTOO ?_____
BOOM BOX ?______
(IF YOU ANSWERED YES TO ANY OF THESE QUESTIONS; DISCONTINUE THIS APPLICATION AND LEAVE THE PREMISES NOW.)
IN 50 WORDS OR LESS, WHAT DOES LATE MEAN TO YOU?
IN 50 WORDS OR LESS, WHAT DOES DO NOT TOUCH MY DAUGHTER MEAN TO YOU ?
IN 50 WORDS OR LESS ,WHAT DOES ABSTINENCE MEAN TO YOU ?
WHAT WOULD BE THE BEST TIME TO INTERVEIW YOUR FATHER,MOTHER,AND MINISTER ?
(ANSWER FILLING IN THE BLANKS, PLEASE ANSWER ALL QUESTIONS FREELY . ALL ANSWERS WILL BE CONFIDENENTIAL.)
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 IN MY BODY I WOULD WANT BROKEN IS_____________.
THE ONE THING I HOPE THIS APPLICATION DOES NO ASK ME ABOUT IS_______________.
IN THE UNFORTUNATE EVENT OF MY UNTIMELY DEATH ,I WOULD LIKE________________ TO BE CONTACTED.
MY GREATESTED FEAR IS_______________________?
WHEN I FIRST MEET A GIRL THE ONE THING I NOTICE ABOUT HER IS________________? (NOTE : IF THE ANSWER TO THE QUESTION STARTS WITH A B, DISCONTINUE AND LEAVE PREMISES-KEEPING HEAD LOW AND RUN AWAY IN A SERPENTINE FASHION.)
WHAT DO YOU WANT TO BE WHEN YOU GROW UP?_______________.
HAVE YOU EVER BEEN FINGERPRINTED ?_____________________.
HAD A DNA SAMPLE TAKEN AND RECORDED ?__________________.
YOUR DENTIST’S NAME IS_________________________________
EMERGANCY # IS___________________.
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, AND RED HOT POKERS.
__________________________________________ Signature (that means sign your name)
NOTE: AFTER SUBMITTING YOUR APPLICATION, PLEASE ALLOW 4-6 YEARS FOR PROCESSING.