name___________ birth date________
social security number _________
mailing addresss_________ physical address _______ ( if different) 
number of dependents___
city___state__zip_____how long?_____
employer?_____ meaningful
work done in last 2 weeks?_____
type? (if yes)_____ salary?_____ charitable
contributions?___________________(if not, why?)
asssets:_____ liabilities:______ heft
of your soul:_____ emotional uncertainties:________
regrets? _____ (if none, cease application)
height:____ weight:____
(n/a is not an option)
velocity:_____ acceleration? _____
do you know excel? _____ do you know
how to excel? 
(if yes, reconsider answer)
are you currently insured?_____ are you
spontaneously combustible?_______ from the hours of
2 to 5?_____
do you require any accommodations for 
not being able to cope with existence? ____ (if not,
pat yourself on the back because you’re now my boss)
any known allergies? ____ drug use?____ drug misuse?____
known hostilities or affiliation to hate or political groups?______ (if so only list the racist ones)
are you sure?