NOTE: This application will be considered incomplete and will be rejected unless accompanied by a complete financial statement, job history, family lineage, and current medical report from your doctor.
SECTION A:
NAME_____________________________________ DATE OF BIRTH_____________
HEIGHT___________ WEIGHT____________ IQ__________ GPA_____________
PIN NUMBER ______________________ DRIVERS LICENSE No._______________
BOYS SCOUT RANK AND BADGES ___________________________________________
HOME PHYSICAL __________________________ POSTAL ADDRESS__________________
CITY/STATE_______________________ COUNTRY ____________________ZIP_______
Do you have parents? ___Yes ___No
Are your parents alive? ___Yes ___No Is one male and the other female? ___Yes ___No
If No, explain:___________________________________________________________
How long have your parents been married _______________________
If they have been married for duration less than your age, explain
______________________________________________________________
______________________________________________________________
SECTION B - ACCESSORIES:
Do you own or have access to:
A. A van? __Yes __No
B. A truck with oversized tyres? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
Do you have an earring, nose ring, pierced tongue, pierced cheek or a belly button ring? __Yes __No
(IF YOU ANSWERED "YES" TO ANY OF THE QUESTIONS IN SECTION B ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
SECTION C - ESSAY WRITING:
In 50 words or less, what does the term "LATE" mean to you?
______________________________________________________________
______________________________________________________________
In 50 words or less, discuss the phrase "DON'T TOUCH MY DAUGHTER"
______________________________________________________________
______________________________________________________________
In 50 words or less, define "ABSTINENCE"
______________________________________________________________
______________________________________________________________
SECTION D - REFERENCES:
I attend church/mosque/temple/synagogue (TICK WHERE APPROPRIATE)
Name and location of the mentioned place of worship _________________________
Frequency of attendance - indicate day(s) of the week and time ______________
When would be the best day and time to interview your:
father? _____________
mother? _____________
pastor/priest/rabbi? _____________
SECTION E - SHORT OR ONE WORD ANSWERS
Please answer truthfully. All answers are confidential.
A: If I were shot, the last place I would want shot would be:
______________________________________________________________
B: If I were beaten, the last bone I would want broken is my:
______________________________________________________________
C: A woman's place is in the:
______________________________________________________________
D: The one thing I hope this application does not ask me about is:
______________________________________________________________
E. What do you want to do IF you grow up? ______________________
F. When I meet a girl, the thing I always notice FIRST about her is:
______________________________________________________________
G. Do you identify in any way with KBL, BAT, Mastermind or any other such companies?____________________________
H. What is the average current going rate for a lodging in Ngara, River Road ,
Nairobi West, and Muindi Mbingu Street ? __________________
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, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_________________________________________________________
Applicant's Signature (that means you, moron!)
_______________________________ ________________________________
Mother's Signature Father's Signature
_______________________________ ________________________________
Pastor/Priest/Rabbi's signature PC, DCIO, OCPD'S SIGNATURE
Thank you for your interest, and it had better be genuine and non-sexual. Should your application be successful, you will be notified in writing. Please do not attempt to call or write (it could be injurious to your health). Should your application be rejected, you will be notified by two gentlemen, one wearing a white collar and the other carrying an AK47 assault weapon.
Please allow four to six years for processing.
SECTION A:
NAME_____________________________________ DATE OF BIRTH_____________
HEIGHT___________ WEIGHT____________ IQ__________ GPA_____________
PIN NUMBER ______________________ DRIVERS LICENSE No._______________
BOYS SCOUT RANK AND BADGES ___________________________________________
HOME PHYSICAL __________________________ POSTAL ADDRESS__________________
CITY/STATE_______________________ COUNTRY ____________________ZIP_______
Do you have parents? ___Yes ___No
Are your parents alive? ___Yes ___No Is one male and the other female? ___Yes ___No
If No, explain:___________________________________________________________
How long have your parents been married _______________________
If they have been married for duration less than your age, explain
______________________________________________________________
______________________________________________________________
SECTION B - ACCESSORIES:
Do you own or have access to:
A. A van? __Yes __No
B. A truck with oversized tyres? __Yes __No
C. A waterbed? __Yes __No
D. A pickup with a mattress in the back? __Yes __No
E. A tattoo? __Yes __No
Do you have an earring, nose ring, pierced tongue, pierced cheek or a belly button ring? __Yes __No
(IF YOU ANSWERED "YES" TO ANY OF THE QUESTIONS IN SECTION B ABOVE, DISCONTINUE APPLICATION AND LEAVE PREMISES IMMEDIATELY. I SUGGEST RUNNING.)
SECTION C - ESSAY WRITING:
In 50 words or less, what does the term "LATE" mean to you?
______________________________________________________________
______________________________________________________________
In 50 words or less, discuss the phrase "DON'T TOUCH MY DAUGHTER"
______________________________________________________________
______________________________________________________________
In 50 words or less, define "ABSTINENCE"
______________________________________________________________
______________________________________________________________
SECTION D - REFERENCES:
I attend church/mosque/temple/synagogue (TICK WHERE APPROPRIATE)
Name and location of the mentioned place of worship _________________________
Frequency of attendance - indicate day(s) of the week and time ______________
When would be the best day and time to interview your:
father? _____________
mother? _____________
pastor/priest/rabbi? _____________
SECTION E - SHORT OR ONE WORD ANSWERS
Please answer truthfully. All answers are confidential.
A: If I were shot, the last place I would want shot would be:
______________________________________________________________
B: If I were beaten, the last bone I would want broken is my:
______________________________________________________________
C: A woman's place is in the:
______________________________________________________________
D: The one thing I hope this application does not ask me about is:
______________________________________________________________
E. What do you want to do IF you grow up? ______________________
F. When I meet a girl, the thing I always notice FIRST about her is:
______________________________________________________________
G. Do you identify in any way with KBL, BAT, Mastermind or any other such companies?____________________________
H. What is the average current going rate for a lodging in Ngara, River Road ,
Nairobi West, and Muindi Mbingu Street ? __________________
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, RED HOT POKERS, AND HILLARY CLINTON KISS TORTURE.
_________________________________________________________
Applicant's Signature (that means you, moron!)
_______________________________ ________________________________
Mother's Signature Father's Signature
_______________________________ ________________________________
Pastor/Priest/Rabbi's signature PC, DCIO, OCPD'S SIGNATURE
Thank you for your interest, and it had better be genuine and non-sexual. Should your application be successful, you will be notified in writing. Please do not attempt to call or write (it could be injurious to your health). Should your application be rejected, you will be notified by two gentlemen, one wearing a white collar and the other carrying an AK47 assault weapon.
Please allow four to six years for processing.
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