THE
COMMITTEE
Real
Name:
Nick
Name: (don’t bother, we will give you one)
Are
you missing any limbs?
Explain______________________________________________________
____________________________________________________________
Do
you suffer from any of the list ailments (check all that apply)
__Delusions
of Graduer
__Multiple
Personalities
__Wussitis
__Couchus
Potatoeis
__Xenophobia
__Electronic
entertainment dependency
__Low
Selfesteem
How
long can you hold your breathe?
If
you went camping and you woke up and their was Vaseline all over your butt would
you tell anyone you had been butt raped? ___ If no, do you want to go camping?
Do you have a problem being photographed? Explain ____________________________________________________________
____________________________________________________________
____________________________________________________________
Have
you ever done porn?___ Would you?___
Marital
Status __single __Married __Divorced (isn’t that the same as single)
If
married, how were you suckered? _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Who
is your Arch-Villian?
Do
they know that they are your Arch Villian?
Please
inform us of anything else you feel we need to know about you, and make it short
cause more than likely we don’t care. ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Signature ________________________________
Date
______________