1. NAME:_Daisuke Ace Zaker DATE OF BIRTH:
_Every Year_
2. HEIGHT:_148-149 cm
T.T__ WEIGHT: _300-350N__IQ: _121___GPA: _NA___
3. SOCIAL SECURITY #: _CITIZEN_DRIVERS LICENSE #:
_No have
license_=(_
4. BOY SCOUT RANK:__No
join boy scout >.<______
5. HOME ADDRESS: __Country of flames____CITY:
_Konoha____ ZIP
_On my
pants__
6. Do you have one MALE and one FEMALE parent? Yes Duh_ No_______ If NO, explain:
________________________________________________
7. Number of years parents married: __too much to count____
8. DO YOU OWN A VAN? _No_ A TRUCK WITH OVERSIZED
TIRES OR CAMPER SHELL? _No_ WATERBED? _No__ MOTORCYCLE?
_No_ TATOO?
_No_ COLOR ALTERED
HAIR? _haven't had any
alteration_ (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? _Late Means late, not being
punctual.__
10. In 50 words or less, what does "DO NOT TOUCH MY GRANDDAUGHTER"
mean to you? _Nice to
see, once broken considered sold _
11. In 50 words or less, what does "ABSTINENCE" mean to you?
_A cheem word that
have no idea of _____
12. What church do you attend? _Church Of Haruhiism__ How
often do you attend? _1/4_/ week
13. When would be the best time to interview your father, mother
and religious teacher? _When they are free__
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 _Heart_
B. If I were beaten, the last bone I would want broken is my
_Spine_
C. A women's place is in the _heart_
D. The one thing I hope this application does not ask me about is
_Sex__
E. When I first meet a girl, the first thing I notice is
_cuteness_ (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? _A writer/
detective/_Toilet
President/ Owner of Manga/Anime Shop/ All of the
above._
16. Do you plan to attend a religious school? _I'm already in one?_ Which
one? _The one I'm currently
in_
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.
__Daisuke__ Signature (That
means sign your name)
