Hackweiser

E-mail us: fuk-china@hushmail.com

Application to be a China Man

Last name: ________________

First name (check appropriate box):

[_] Chink Wu Lang
[_] Tsai Truk
[_] wang g00k
[_] wang bang
[_] wang slant
[_] wang lee
[_] wang lame

Age: ____ (if unsure, guess)

Sex: ____ M _____ F _____ Not sure

Shoe Size: ____ Left ____ Right

Occupation:

[_] Farmer                  [_] Rice Muncher
[_] Baby Killer            [_] China Script Kiddie
[_] Unemployed          [_] Dirty Politician

Spouse's Name:           __________________________
2nd Spouse's Name:      _________________________
3rd Spouse's Name:      _________________________
Lover's Name:            ____________________________
2nd Lover's Name:       __________________________

Relationship with spouse:

[_] Sister              [_] Aunt
[_] Brother           [_] Uncle
[_] Mother            [_] Son
[_] Father             [_] Daughter
[_] Cousin            [_] Pet

Number of children living in household: ___
Number of children living in shed:      ___
Number of children that are yours:      ___

Mother's Name: _______________________
Father's Name: _______________________ (If not sure, leave blank)

Education: 1 2 3 4 (Circle highest grade completed)

Do you [_] own or [_] rent your stolen US plane?

Vehicles you own and where you keep them:

___ Total number of vehicles you own
___ Number of vehicles that still crank
___ Number of vehicles in front yard
___ Number of vehicles in back yard
___ Number of vehicles on cement blocks

Firearms you own and where you keep them:

____ truck        ____ kitchen
____ bedroom     ____ bathroom
____ shed

Model of your pickup: _____________     and year: 194__

Do you have a rice patch?

[_] Yes [_] No; If no, please explain:

Newspapers/magazines you subscribe to:

[_] 2600 China
[_] Rice-R-Us
[_] Wang Fu

___ Number of times you've seen an American
___ Number of times you've masterbated to an American pic

How often do you bathe:

[_] Weekly
[_] Monthly
[_] Not Applicable

How many teeth? ___

Color of teeth:

[_] Yellow               [_] Brownish-Yellow
[_] Brown               [_] Black
[_] N/A

How far is your home from a paved road?

[_] 1 mile
[_] 2 miles
[_] don't know

X_________________________________________ Date____________________________