Application For Employment
Prospective employees shall be afforded equal
opportunity. However making a slight donation
of $50.00 to the receptionist will improve the
chances of your completed application making it
to the H.R. Dept.
All information that you release in this application
will probably be viewed by the receptionist, her
boyfriend, the cleaning lady, our telephone repairman,
the pizza delivery boy, and potentially anyone who
walks by the desk your application is laying on.
1. Position Applied For: ___ Eye Candy ___ Tattletale ___ Sucker ___ Head Cheese
2. Are you a Brown-Noser? ___ Yes ___ No
3. Can you pass a lie detector test? ___Yes ___ No
( If you answered 2 out of 3 questions with a yes please proceed to fill out the rest of the application. If you answered no to any of the above
questions we are sorry to inform you that the position has already been filled. Please toss this application in the trash on your way out of the
building ).
Last Name: _____________________ Middle Initial: ____ First Name: _____________________
Social Security No. ____________________ Credit Card No. ____________________ Exp. ______
Bank Name: __________________________ Acct. No. ___________________________________
Mailing Address: ____________________________________________________________________
(Must be the same as your billing address for credit card).
Have you ever been admitted to a mental institution? ____ Yes ___ No
If yes, why did you want to leave there and apply for work here? _______________________________
___________________________________________________________________________________
Have you ever been convicted of a felony? ____ Yes ___ No
( If yes, what the hell are you still doing filling out this application? See above question no. 3 )
Are you married? ___ Yes ___ No
Date of birth: ___________________________
Favorite Drink: _________________________
Horoscope Sign: ________________________
Home Phone: ___________________________
Email Address: ________________________
Do you own your home? ___ Yes ___ No
Favorite Bar: ___________________________
Favorite Color: _________________________
Car Make/Color: ________________________
Cell Phone: ____________________________
Chat Handle: _________________________
Please list any emotional hang-ups that you have in the space below and include a list of meds that you
take for this:
____________________________________________________________________________________
____________________________________________________________________________________
I hereby attest and verify that the information I have provided in this application is absolutely false and misrepresented. I understand that any
honest or true answers could lead to me spending the rest of my life alone.
Signature:______________________________ Date:_________________________