Title: Jerry Springer anyone?? Post by: ifm on August 03, 2006, 04:42:32 PM Application form for the Jerry Springer Show Last name: ________________
First name: (Tick appropriate box) (_) Chardonay (_) Courtney (_) Chantelle (_) Dave age ____ (if unsure, guess) _____ Not sure Shoe Size: ____ Left ____ Right Occupation: (Check appropriate box) (_) Scally (_) Hair Dresser (_) Unemployed Spouse's Name: _________________________ 2nd Spouse's Name: ______________________ 3rd Spouse's Name: ______________________ Lover's Name: ___________________________ Relationship with spouse: (Check appropriate box) (_) Sister (_) Brother (_) Aunt (_) Uncle (_) Cousin (_) Mother (_) Father (_) Son (_) Daughter (_) Pet Number of children living in household: _____ Number of children living in shed: ______ Number that are yours: ______ Mother's Name: _______________________(If not sure, leave blank) Father's Name: _______________________(If not sure, leave blank) Total number of vehicles you own: ___ Number of vehicles that you stole: ___ Number of vehicles in front yard: ___ Number of vehicles in back yard: ___ Number of vehicles on bricks ___ Weapons you own and where you keep them: ____ bedroom ____ bathroom ____ kitchen ____ shed Model and year of your car: 196_ Number of times you've been to court -------- Number of times you've been to court and it wasn't your fault.......... How often do you bathe: (_) Weekly (_) Monthly (_) Not Applicable Colour of eyes: Right_____ left_____ Colour of hair: (_) Blond (_) Red (_) Bleached Colour of teeth: (_) Yellow (_) Brownish-Yellow (_) Brown (_) Black (_) N/A Title: Re: Jerry Springer anyone?? Post by: Indestructable on August 03, 2006, 04:54:10 PM Where do I send the form to?
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