Applecation For Membership

Today's Date: Yesterday's Date:

Purpose of this application: membership in :
Bavarian Illuminati San Lorenzo Entropic Maximum
None of the above All of the above
Other (be specific!):

Name: Holy Name:

Address:
(If temporary, also give an address from which mail can be forwarded)

Description

Born: no yes of virgin
Eyes: 2 other
Height: fl. oz.

Last time you had a haircut:
Reason:

IQ: 150 - 200 200 - 250 250 - 300 over 300
Race: horse human Grey YHWH
Other (be specific!):

History

Education - highest grade completed: 1 2 3 4 5 6 over 6th

Professional - List every job since 1937 from which you have been fired.

Medical - "Confidential" List all major psychotic episodes experienced within the last 24 hours.

Sneaky Questions to establish personality traits

I would rather: watch 96 hours of Cartoon Network. play in a rock group. eat caterpillars.

I wear obscene tattoos because:

I have ceased raping little children: yes no
Reason:

Self Portrait

Place URL of a self-portrait image here.

to the San Lorenzo Processing Center and Meat Locker
For Office Use Only: accept reject burn