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____________________________