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(From: JIM DAMICO DTN: 261-3257)

Forms for NH and MA

Application for Permission to Live in New Hampshire

NAME:  

ETHNIC INFORMATION: (voluntary) 
White ( ) 

TYPE OF CARS OWNED: 
Pickup Truck ( ) 
You don't own any Foreign cars, do you?  NO ( ) 

CAR EQUIPMENT: 
Gun Rack ( )  Stash ( )       CB ( )  Beer Holder ( ) 
Playboy air freshener ( ) 

BUMPER STICKERS: 
"Ex-wife in trunk" ( )         
"If Guns are Outlawed, Only Outlaws Will Have Guns" ( )  
"Bush/Quayle" ( )   
"Shit Happens" ( ) 
"If you don't like my driving, get off the sidewalk" ( ) 

SEXUAL ORIENTATION:   Heterosexual ( )                 

FAVORITE CAUSE:  NRA ( )      Pro-life ( )         

Total given to these causes in the last 12 months:  

FAVORITE DRUGS:  
Grass ( )      

WHICH OF THE FOLLOWING SHOULD BE BANNED?: 
(check all that apply) 
Democrats ( )     Welfare ( )   N.O.W. ( )     

FAVORITE BEER: 
Miller ( )    Michelob ( )    Bud ( )  

FAVORITE POLITICIAN: 
Don't Care ( ) 

CLUB MEMBERSHIPS: 
NRA ( ) 

How Automatic Weapons do you own? 

5 ( ) 10 ( )  More than that ( ) 

FAVORITE TV SHOW:   Benny Hill ( ) 



Application for Permission to Live in Massachusetts

NAME:  
(extra space left due to new social awareness) 

ETHNIC INFORMATION: (voluntary) 
Eskimo ( )    American Indian ( )     Hispanic ( )    Asian ( ) 
African-American ( )  American-African ( )    Black-American ( ) 
Other Group With A Long History Of Oppression By White Males ( ) 
(specify, so we can help you form a political action group) 

        

TYPE OF CARS OWNED (pick two): 
SAAB ( )      Volvo ( )       BMW ( )    Mercedes ( )   Honda ( ) 

You don't own any American cars, do you?  NO ( ) 

CAR EQUIPMENT: 
Blaupunkt ( ) Passport ( )    Escort ( )      Vuarnet Sunglasses ( ) 
Stash ( )     CD ( )  Cellular Phone ( )      Ski Rack ( )  
Bicycle Rack ( )      Wine Rack ( ) 

BUMPER STICKERS: 
"You can't hug a child with nuclear arms" ( ) "Greenpeace" ( )  
"Dukakis/Bentsen" ( )  "Save the Whales" ( )  "Farms not Arms" ( ) 

SEXUAL ORIENTATION:   Gay ( )         Lesbian ( )     Other ( ) 
(note: failure to give the proper answer to the above means you can't  
live in certain towns on the Cape, or get elected to Congress) 

FAVORITE CAUSE:  Whales ( )   Baby Seals ( )     Snail Darter ( ) 
Total given to these causes in the last 12 months:  

FAVORITE DRUGS:  
Crack ( )     Coke ( )        Grass ( )       Kitty's Diet Plan ( ) 

WHICH OF THE FOLLOWING SHOULD BE BANNED?: 
(check all that apply) 
The Bomb ( )  Handguns ( )    All guns ( )   Nuclear Power ( ) 
Cigarettes ( )          The NRA ( )   Republicans ( ) 

WHICH OF THE FOLLOWING SHOULD BE LEGALIZED?: 
(check all that apply) 
Crack ( )     Coke ( )        Grass ( )       Needles ( ) 
Flag Burning ( ) 

FAVORITE BEER: 
Samuel Adams ( )      Beck's ( )      Corona(w/lime) ( )       
Latest trendy brand ( ) 

FAVORITE POLITICIAN: 
Ted Kennedy ( )         John Kennedy ( )      Bobby Kennedy ( ) 
Joe Kennedy ( ) 

CLUB MEMBERSHIPS: 
ACLU ( )      Greenpeace ( )      SDS ( )     N.O.W. ( )   A.F.S.C.M.E ( ) 
Billy Bulger Breakfast Club ( )          Provincetown Boys Club ( ) 
Bull-dykes Kennel Club ( )     

Even though we can't ever get any more power from Hydro-Quebec, don't 
you think that Seabrook should remain closed forever?   YES ( ) 

Don't you think that the people in the Midwest should stop dropping acid  
rain on our vacation homes in Vermont, even if it means that they all lose  
their jobs?   YES ( ) 

How many watts (per channel, RMS) is your principal home stereo? 
100W ( )      200W ( )        More than that ( ) 

How many air conditioners do you have to help you through our long New  
England summers?:     2 ( )   3 ( )   4 ( )   Central Air ( ) 
 (note: Fewer than two A/C units may qualify you for state  
  subsidies if you are a non-white unemployed Democrat) 

FAVORITE TV SHOW:  Thirtysomething ( )  

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