bencar
11-11-2004, 08:18 AM
Okay, this isn't really an application to the Jerry Springer Show, but it sure could be :D
SPRINGER APPLICATION
Guest Application for The Jerry Springer Show
Personal information:
Name_______ Nickname_________ CB Handle_________
Yore Mama_________ Yore Daddy (if known)___________
Spouse's Name_________*
*Relationship to spouse: ___Sister __Brother __Mother __Father __Pet __Aunt __uncle
Occupation: __unemployed Mechanic ___Gun show Dealer __Slci nhead
Number of Children in Household__ Number that are yours__
Circle Highest Level of Education: 1 2 3 4
how Far is Your Mobile Home From a Paved Road: ___ 1 mi. ___5 mi.
___?
Number of Times You Have Survived a Tornado: __
Number of vehicles Owned__ Number on Cement Blocks__
Truck Equipment: __Gun Rack __Pit Bull __Spit Cup __Fuzzy Dice __Rebel
Flag__ Naked woman Mudflaps NWO and/or NRA sticker
Weapons Owned: ___Tire iron __Pick Handle ___Beer Bottle ___Shotgun
Number of Dogs Owned: __
Number of Homemade Tattoos____
Which of the Following Appliances are in your Front Yard:
___Frigerator____Heatin Stove ___Warsher ___TV ___Freezer
How Many of the Above Appliances work: __
Fav-o-rite Recreation: ___Drinkin ___Cow Chip Throwin
___Possum Huntin___Crawdad Huntin __Spittin Backy
__Scratchin __Watchin wrasslin
If You Can Read, which Magazines Do you Prefer: __soap opera Digest ___NWA ___Rifle and Shotgun ____NWA
___TV Guide ___National Enquirer __True confessions
SPRINGER APPLICATION
which stinks worse: __Hogpen __outhouse __Spouse
can you Spell Your Last Name:__Yup __Nope
can you Remember Your Last Name: __Yup __Nope
Have you Ever stayed sober for More Than one Day: __Yup __Nope
Do you Know Any words with More Than 4 Letters: __Yup __Nope
which is Correct: __"I seed Him" or __"I seen Him"
how Many cartons of cigarettes do you Smoke a Day? __
Math Test: how Many Food stamps do the Following Cost? __six Pack __ciggies __shotgun shells __Backy__ Prosti tute__
Number of Times You've seen: __a ufo __ Elvis__Elvis in a ufo
Health Questionaire: which of the Following do you Have? __Head Lice __B.o. __crabs __Runny Nose__Boils
Can you Remember the Last Time you Bathed? __Yup__Nope
Color of Teeth: __Yellow __Brown __Black __N/A
I hereby swear this is the trooth and sign my "x" on ___20_
page 2
Oh, and is there somethign wrong with Edison, the Applebees, or did I just pick a bad day to decide to simply drop by there, and maybe meet a few folks live and in person there :?:
SPRINGER APPLICATION
Guest Application for The Jerry Springer Show
Personal information:
Name_______ Nickname_________ CB Handle_________
Yore Mama_________ Yore Daddy (if known)___________
Spouse's Name_________*
*Relationship to spouse: ___Sister __Brother __Mother __Father __Pet __Aunt __uncle
Occupation: __unemployed Mechanic ___Gun show Dealer __Slci nhead
Number of Children in Household__ Number that are yours__
Circle Highest Level of Education: 1 2 3 4
how Far is Your Mobile Home From a Paved Road: ___ 1 mi. ___5 mi.
___?
Number of Times You Have Survived a Tornado: __
Number of vehicles Owned__ Number on Cement Blocks__
Truck Equipment: __Gun Rack __Pit Bull __Spit Cup __Fuzzy Dice __Rebel
Flag__ Naked woman Mudflaps NWO and/or NRA sticker
Weapons Owned: ___Tire iron __Pick Handle ___Beer Bottle ___Shotgun
Number of Dogs Owned: __
Number of Homemade Tattoos____
Which of the Following Appliances are in your Front Yard:
___Frigerator____Heatin Stove ___Warsher ___TV ___Freezer
How Many of the Above Appliances work: __
Fav-o-rite Recreation: ___Drinkin ___Cow Chip Throwin
___Possum Huntin___Crawdad Huntin __Spittin Backy
__Scratchin __Watchin wrasslin
If You Can Read, which Magazines Do you Prefer: __soap opera Digest ___NWA ___Rifle and Shotgun ____NWA
___TV Guide ___National Enquirer __True confessions
SPRINGER APPLICATION
which stinks worse: __Hogpen __outhouse __Spouse
can you Spell Your Last Name:__Yup __Nope
can you Remember Your Last Name: __Yup __Nope
Have you Ever stayed sober for More Than one Day: __Yup __Nope
Do you Know Any words with More Than 4 Letters: __Yup __Nope
which is Correct: __"I seed Him" or __"I seen Him"
how Many cartons of cigarettes do you Smoke a Day? __
Math Test: how Many Food stamps do the Following Cost? __six Pack __ciggies __shotgun shells __Backy__ Prosti tute__
Number of Times You've seen: __a ufo __ Elvis__Elvis in a ufo
Health Questionaire: which of the Following do you Have? __Head Lice __B.o. __crabs __Runny Nose__Boils
Can you Remember the Last Time you Bathed? __Yup__Nope
Color of Teeth: __Yellow __Brown __Black __N/A
I hereby swear this is the trooth and sign my "x" on ___20_
page 2
Oh, and is there somethign wrong with Edison, the Applebees, or did I just pick a bad day to decide to simply drop by there, and maybe meet a few folks live and in person there :?: