Jerry Springer anyone??

[ifm]

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

[Indestructable]

Where do I send the form to?