GREATER LOS ANGELES AREA DRIVER'S LICENSE APPLICATION


Name: ____________________
Stage name: __________________________
Agent's Name:  __________________________
Attorney's Name:  _______________________
Actual Age: _____ Admitted Age: _____
Sex:  [ ]  male              [ ] female
[ ] formerly male  [ ] formerly female
[ ] both               [ ] neither
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 [ ]
Occupation:
[ ]  Lawyer
[ ]  Actor/Waiter
[ ]  Film-maker/Self-employed
[ ]  Writer
[ ]  Car Dealer
[ ]  Pan-handler
[ ]  Agent
[ ]  Hooker/Transvestite
[ ]  Other; please explain: ___________________________

Please list brand of cell phone:  ________________________ (If you don't own a cell phone,  please explain.)
Please check hair color:
     Females:     [  ] Blonde    [  ]   Platinum  Blonde
     Teenagers:   [  ] Purple    [  ]   Blue      [  ] Skin-head
Men: Please list shade of hair plugs ________________
Please indicate if you have Automobile Insurance:
[ ] Yes [ ] No
If Yes, please explain:
Please check activities you perform while driving (Check all that apply):
[ ] Eating a wrap
[ ] Applying make-up
[ ] Talking on the phone
[ ] Slapping kids in the back seat
[ ] Applying cellulite treatment to thighs [ ] Tanning [X] Snorting cocaine (already checked for ease of application)
[ ] Watching TV
[ ] Reading Variety
[ ] Surfing the net via laptop
[ ] Reading a book or other Newspaper

Please indicate how many times:
a)	you expect to shoot at other drivers, _____
b)	and how many times you expect to be shot at while driving
    ____.

If you are the victim of a car-jacking, you should immediately:
a)	[ ] Call the police to report the crime;
b)	[ ] Call Channel 4 News to report the crime, then watch your TV;
c)	[ ] Call your attorney and discuss lawsuit against cellular phone company for 911 call not going through;
d)	[ ] Call your therapist;
e)	[ ] None of the above (South Central residents only).

Please indicate if you drive:
a)	[ ] a BMW,
b)	[ ] a Lexus,
c)	[ ] a Mercedes,
d)	[ ] a Cabriolet.

If your answer is d, please add 6 to 8 weeks to normal delivery time for your driver's license.
In the event of an earthquake, should you:
a)	[ ] stop your car
b)	[ ] keep driving and hope for the best,
c)	[ ] immediately use your cell phone to call all loved ones, or
d)	[ ] pull out your video camera and obtain footage for Channel 4?

In the instance of rain, you should:
a)	[ ] never drive over 5 MPH,
b)	[ ] drive twice as fast as usual, or
c)	[ ] you're not sure what "rain" is.

Please indicate number of therapy sessions per week:  ____.
Are you presently taking any of the following medications?
(Check all that apply.)
a)	[ ] Prozac;
b)	[ ] Zovirax;
c)	[ ] Lithium;
d)	[ ] Zanax.
If none, please explain:  __________________.
Length of daily commute:
a)	[ ] 1 hour;
b)	[ ] 2 hours;
c)	[ ] 3 hours;
d)	[ ] 4 hours or more.
If under 1 hour, please explain:
When stopped by police, should you
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 405,
c)	[ ] have video camera ready and provoke them to attack, thus ensuring yourself of a hefty lawsuit?



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