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Name: _____________________________

Nickname: _____________________________

Address: _____________________________

Exit # (NJ Turnpike): _______

Exit # (Garden State Parkway): _______

Ethnic Background: ___Italian ___Sicilian ___Jewish ___Italian ___Italian

Profession: ___Mechanic ___Truckdriver ___Meatpacker ___Dockworker ___Hairdresser ___Manacurist ___Avon Sales Lady ___Waitress @Bennigan's___Exotic Dancer

Backyard Smells Like: ___Sewage ___Sulfur ___Garbage ___All 3

# of Muscle Shirts Owned: ___5-10 ___10-15 ___15-20 ___20 and above

# of Bon Jovi Tour Shirts Owned: ___5-10 ___10-15 ___15-20 ___20  and above

# of Bon Jovi Shirts That are Also Muscle Shirts: ___5-10 ___10-15 ___15-20 ___20 and above

Brand of Jeans Preferred: ___Sergio Valente ___Jordache ___Sassoon___Z.Cavaricci

Percentage of Wardrobe Which is Skintight: ___100% ___95-100% ___90-95% ___85-90%

# of Gold Chains Owned: ___10-15 ___15-20 ___20-25 ___25 and above

# of Gold Chains Worn at One Time: ___5-10 ___10-15 ___15-20 ___20 and above

Approximate Value of ALL jewelry: ___$5-$10 ___$10-$15 ___$15-$20___Stolen

Number of Applications of Obsession/Polo/Drakar Before Going Out: ___10-15___15-25 ___25 and above

Gold Cap on at Least One Tooth? ___Yes ___No

Hair Height (must be completed by applicants seeking residency in Edgewater or Bayonne) ___6-8 inches ___8-12 inches ___1-2 feet___More than 2 feet

Hair Products Used: ___Hair Spray ___Styling Gel ___Mouse ___Extra

Hold Styling Gel: ___Bondo ___Spackle ___40 Weight Oil ___Krazy Glue

Automobile Owned: ___IROC Z ___Firebird ___Camaro___Mustang___Thunderbird

Number of Inches Car is Off the Ground: ___6-8 inches ___4-6 inches___2-4 inches ___Under 2 inches

Car Paraphernalia:___Gold chain around license plate ___Neon lights around license plate ___Neon lights under car ___Chippendales/Playboy air freshener hanging on rear view mirror ___Garter hanging from rear view mirror ___Chrome hubcaps ___Stick-on window tinting ___Stick-on paint splash stickers ___Fuzzy dice TATTOO ___Crown deodorizer on dash or in rear window


Favorite Sports Team:

___F*#&in' Giants

___F*#&in' Jets

___F*#&in' Mets

___F*#&in' Yankees

___F*#&in' Nets

___F*#&in' Knicks

___F*#&in' Devils

___F*#&in' Rangers

___F*#&in' Islanders


Favorite Music: ___Techno ___Rap ___Bon Jovi ___Bruce Springsteen

Favorite Actor/Actress: ___Joe Pesci ___Robert DeNiro ___Al Pacino ___Marisa Tomei___Annette Funicello ___Anna Magnani

Favorite Movie: ___The Godfather ___The Godfather Part II ___The Godfather Part III___Goodfellas ___My Cousin Vinnie

Favorite Profanity (proceeded by YO!): ___Motherf?%er ___C*&%sucker___Jerkoff ___Scumbag ___Douche Bag

# of Religious Statutes at Grandparents House: ___5-10 ___10-15 ___15-20___20 and above

Relatives Named "Sal" ___5-10 ___10-15 ___15-20 ___20 and above


Favorite International Destination:


___Seaside Heights

___Point Pleasant


___Great Adventure



Favorite Driving Technique


___Attacking stop signs

___Doing 106 mph on the right shoulder of the parkway

___Giving the finger to slow, elderly drivers (non-related)

___Giving the finger to slow, elderly drivers (own grandparents)

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