It isn’t necessary to attach a photo since you all look alike.
Name: _________________________________________
Address: _____________________________________
(If living in automobile, give make, model, & license number)
Gang: _________________________________________
Name of Mutha: ______________________
Name of Fatha (if known): _____________________
Type of building in which you live: Shack ___ Ghetto slum ____ Public housing ___
Homeless shelter ___ Cardboard box
Place of Birth: Charity Hospital ___ Free Public Hospital ___ Cotton Patch ___
Back Alley ___ Zoo ___
Education (if any): Grade school ___ High School ___ College ___
If college, how financed? Basketball scholarship ___ United Negro College Fund _
Marital Status: Single ___ Common-law ___ Shacked-up ___
Number of known children you have: 1st wife: _____ 2nd wife: _____ 3rd wife: _____
Nieghbor’s wife: _____ Shack-ups: _____
Check qualifications you have: Preacher ___ Gov’t employee ___ Demonstration leader ___
Hubcap salesman ___ Rapist ___ Waterbed demonstrator ___ Gang leader ___
Controlled substances distributor ___
How many words do you rap a minute? _____
Current legal status: On parole ___ Out on bail ___ Fugitive ___ Other ___
Type of auto you drive: Cadillac ___ Lincoln ___ BMW ___ Other ___________
Was this car: Financed? ___ Stolen? ___
If financed, give repossession date: __________________
Check foods you like best: Barbeque ___ Fried chicken ___ Carp ___ Coon ___ Possum ___ Chitlins ___ Watermelon ___ Muskrat ____
List your estimated yearly income: Theft $_______ Welfare $_______ Unemployment $_______
List your greatest desire in life (other than a white girl): ________________________________
P.S. Nu sunt rasista,chiar mi se par draguti negrii, dar mi s-a parut prea amuzant ca sa nu il impartasesc cu voi.