Hello Dreamer.
He certainly would have been the ideal contestant for Mr. Springer`s highly intellectual production. Let us trust the cadet remembered to take his flagon of moonshine before he was sent on his intergalactic sojourn.


Guest Application For Jerry Springer Show
Personal Information:
Name___________ Nickname______________ CB Handle______________
Yore Mama______________ Yore Daddy (if known)________________
Spouse's Name_________________
Relationship to spouse: __Sister __Brother__Mother__Father __Pet
__Aunt __Uncle ___ Several of the above
Occupation: ___Unemployed Mechanic ___Gun Show Dealer___Skinhead
Number of **** in Household___ Number that are yours___
Circle Highest Level of Education: 1 2 3 4 How many times each grade___________
How Far is Your Mobile Home From a Paved Road: ___1mi. __5 mi. ___?
Number of Times You Have Survived a Tornado: ___
Number of Vehicles Owned___ Number on Cement Blocks___ Number Repossessed___
Truck Equipment: ___Gun Rack ___Spit Cup ___Fuzzy Dice ___Rebel Flag
___Naked Woman Mudflaps ___NWO and/or NRA sticker
Weapons Owned: ___Tire Iron ___Pick Handle ___Beer Bottle ___Shotgun
Number of Dogs Owned: ___
Number of Homemade Tattoos:___
Which of the Following Appliances are in your Front Yard:
___Friggerator ___Heatin Stove ___Warsher ___TV ___Freezer
How Many of the Above Appliances Work: ___
Fav-o-rite Recreation: ___Drinkin ___Cow Chip Throwin ___Possum Huntin
___Crawdad Huntin ___Scratchin ___Watchin Wrasslin
If You Can Read, Which Magazines Do You Prefer:
___Soap Opera Digest ___NWA ___Rifle and Shotgun ___NWA
___TV Guide __National Enquirer ___True Confessions
Which Stinks Worse: ___Hogpen ___Outhouse ___Spouse
Can You Spell Your Last Name:___Yup ___Nope
Can You Remember Your Last Name: ___Yup ___Nope
Have You Ever Stayed Sober for More Than One Day: ___Yup ___Nope
Do You Know Any Words with More Than 4 Letters: ___Yup ___Nope
Which is Correct: ___"I Seed Him" or ___"I Seen Him"
How Many Cartons of Cigarettes Do You Smoke a Day? ___
Math Test: How Many Food Stamps Do the Following Cost?
___Six Pack ___Cigs ___Shotgun Shells ___Whore
Number of Times You've Seen: ___a UFO ___ Elvis___Elvis in a UFO
Health Questionaire: Which of the Following Do You Have?
___Head Lice ___B.O. ___Crabs ___Runny Nose___Boils
Can You Remember the Last Time You Bathed? ___Yup___Nope
Color of Teeth: ___Yellow ___Brown ___Black ___N/A
I hereby swear this is the trooth and sign my "X" on _________20__