bshl 0 #1 April 9, 2004 Name: ___________________ Stage Name: __________________ Agent: ___________________ Attorney: ____________________ Therapist name: _________________ Sex: [ ] Male [ ] Female [ ] Formerly Male [ ] Formerly Female [ ] Both *If female, indicate breast implant size: _______ Will the size of your implants hinder your ability to safely operate a motor vehicle in any way? [ ] Yes [ ] No___ Please list brand of cell phone: ________. If you don't own a cell phone, please explain why; use extra pages, if necessary: _______________________________________________ Please check hair color: Females: [ ] Blonde [ ] Platinum Blonde Teenagers: [ ] Red [ ] Orange [ ] Green [ ] Purple [ ] Blue [ ] Skinhead [ ] Other ___________ Please check activities you perform while driving: (Check all that apply) [ ] Eating [ ] Drinking Starbucks coffee [ ] Applying make-up [ ] Shaving (male or female) [X] Talking on the phone (already checked for your convenience) [ ] Lifting weights [] Slapping kids in the back-seat [] Applying cellulite treatment to thighs [] Tanning [] Snorting cocaine [] Watching TV [] Reading Variety [] Surfing the net via laptop [] Discharging firearms / Reloading Please indicate how many times, while driving, you expect to: [ ] a) Shoot at other drivers [ ] b) Be shot at If you are the victim of a carjacking, you should immediately: [ ] a) Call the police to report the crime. [ ] b) Call Channel 9 News to report the crime, then watch your car on the news in a high-speed chase. [ ] c) Call your attorney and discuss lawsuit against cellular phone company for 911 call not going through. [ ] d) Call your therapist. In the event of an earthquake, you should : [ ] a) Stop your car. [ ] b) Keep driving and hope for the best. [ ] c) Immediately use your cell phone to call all loved ones. [ ] d) Pull out your video camera and obtain footage for Channel 9 In the instance of rain, you should: [ ] a) Never drive over 5 MPH. [ ] b) Drive twice as fast as usual. [ ] c) You're not sure what "rain" is. Please indicate your current number of therapy sessions per week: ______. Are you presently taking any of the following medications? [ ] a) Prozac [ ] b) Zovirax [ ] c) Lithium [ ] d) Zanax [ ] e) Valium [ ] f) Zoloft [ ] g) All of the above [ ] h) None of the above If none, please explain: __________________. Length of daily commute: [ ] a) Less than 1 hour [ ] b) 1 hour [ ] c) 2 hours [ ] d) 3 hours [ ] e) 4 hours or more If less than 1 hour, please explain: ____________________. When stopped by police, you should: [ ] a) Pull over and have your driver's license and insurance form ready. [ ] b) Try to outrun them by driving the wrong way on the 405Freeway. [ ] c) Have your video camera ready and provoke them to attack, thus ensuring yourself of a hefty lawsuit profit. When you see a woman driver with her arm extended out the window, it means: [ ] a) She is drying her nails. [ ] b) She is giving an indication she intends to change lanes. [ ] c) Her directional signals are broken. Which part of your car will wear out first? [ ] a) The wiper blades [ ] b) The seat belts [ ] c) The horn Automatic door locks are good for: [ ] a) Security [ ] b) Convenience [ ] c) Messing with the heads of people trying to get in The "bright" setting on your headlights is for: [ ] a) Dark, poorly lit roads [ ] b) Flashing to get the car ahead to move out of the way [ ] c) Revenge! If you are over the age of 75, you do not have to complete this test. You are entitled to drive even if you cannot see, hear, or move. Blue skies and happy landings! Quote Share this post Link to post Share on other sites
champu 1 #2 April 9, 2004 actually it looks like this... ...oh wait it was a joke, I see. Quote Share this post Link to post Share on other sites
bshl 0 #3 April 9, 2004 [shaking head] Some people's kids... Blue skies and happy landings! Quote Share this post Link to post Share on other sites
