(REVOCABLE AT ANY TIME)
NOTE – This application will be Incomplete and rejected unless accompanied by a complete financial statement, job history, lineage, and current medical report from your doctor.
1. NAME:___ DATE OF BIRTH: ___
2. HEIGHT:___ WEIGHT: _IQ: ____GPA: _
3. SOCIAL SECURITY #: _DRIVERS LICENSE #: _
4. BOY SCOUT RANK:_______
5. HOME ADDRESS: ___CITY: __ ZIP
6. Do you have one MALE and one FEMALE parent? Yes_ No__ If NO, explain: ________
7. Number of years parents married: ___
8. DO YOU OWN A VAN? A TRUCK WITH OVERSIZED TIRES OR CAMPER SHELL? _ WATERBED? __ MOTORCYCLE? __ TATOO? _ COLOR ALTERED HAIR? _ (IF YES TO ANY PART OF #8, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY)
9. In 50 words or less, what does “Late” mean to you? _________
10. In 50 words or less, what does “DO NOT TOUCH MY DAUGHTER” mean to you? _________
11. In 50 words or less, what does “ABSTINENCE” mean to you? _________
12. What church do you attend? ___ How often do you attend? _/ week
13. When would be the best time to interview your father, mother, priest or pastor? __
14. Fill in the blanks: Please answer freely – all answers are confidential (That means I won’t tell anyone – I promise):
A. If I were shot, the last place on my body I would want to be wounded is in the ___
B. If I were beaten, the last bone I would want broken is my ___
C. A women’s place is in the ____
D. The one thing I hope this application does not ask me about is ____
E. When I first meet a girl, the first thing I notice is ___ (NOTE: If the answer to “E” begins with a B, T, or A, discontinue and leave the premises immediately with your head hung low.)
15. What do you want to be IF you grow up? _____
16. Do you plan to attend a Catholic or Christian College? _ Which one? __
I SWEAR THAT ALL INFORMATION SUPPLIED ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE UNDER PENALTY OF DEATH, DISMEMBERMENT, NATIVE AMERICAN ANT TORTURE, CRUCIFIXION, ELECTROCUTION, CHINESE WATER TORTURE, AND RED HOT POKERS.
_____ Signature (That means sign your name)
Thank you for your interest. Please allow four to six years for processing. You will be contacted in writing if you are approved. Please do not try to call or write (this action will void this application). If your application is rejected you will be notified by two angels wearing red suits and carrying pitch forks. (You might want to start praying now). itch forks. (You might want to start praying now).
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