NAME:____________________________  Nickname:_______________________
 ADDRESS: ________________________
 EXIT #: _________________________
 
 
 PLASTIC STATUE ON FRONT LAWN:
 a) St. Christopher  b) Flamingo  c) Kid Peeing  d) All of the above
 
 BACKYARD SMELLS LIKE:
 a) Sewage  b) Sulfur  c) Garbage  d) Old tires  e) All of the above
 
 TOTAL NUMBER OF MUSCLE SHIRTS:
 a) 5 - 10         b) 10 - 15     c) 15 - 20     d) 20 and above
 
 NUMBER OF BON JOVI TOUR SHIRTS:
 a) 5 - 10         b) 10 - 15     c) 15 - 20     d) 20 and above
 
 NUMBER OF BON JOVI TOUR SHIRTS THAT ARE ALSO MUSCLE SHIRTS
 a) 5 - 10         b) 10 - 15     c) 15 - 20     d) 20 and above
 
 BRAND OF JEANS PREFERRED:
 a) Sergio Valente  b) Jordache   c) Sassoon     d) Z. Cavaricci
 
 PERCENTAGE OF WARDROBE WHICH IS LEATHER:
 a) 100%             b) 95-100%       c) 90-95%        d) 85-90%
 
 TOTAL NUMBER OF GOLD CHAINS OWNED:
 a) 10 - 15       b) 15 - 20     c) 20 - 25     d) 25 and above
 
 NUMBER OF GOLD CHAINS WORN AT ONE TIME:
 a) 5 - 10        b) 10 - 15     c) 15 - 20     d) 20 and above
 
 APPROXIMATE VALUE OF ALL THIS JEWELRY:
 a) $ 5 - $10     b) $10 - $15   c) $15 - $20   d) Stolen
 
 NUMBER OF APPLICATIONS OF OBSESSION/POLO/DRAKAR TO ACHIEVE DESIRED
 EFFECT:
 a) 10 - 15          b) 15 - 25        c) 25 and above
 
 VISIBLE GOLD CAP ON AT LEAST ONE TOOTH?    YES _______  NO _______
 
 NUMBER OF VISIBLE GOLD CAPS:
 a) 1          b) 2-4        c) 5 or more
 
 HAIR HEIGHT:
 a) 6-8 Inches   b) 8-12 Inches  c) 1-2 feet   d) Shaved (women only)
 
 HAIR PRODUCTS USED AT ANY GIVEN TIME:
 (check all that apply)
 a) Hair Spray
 b) Styling Gel
 c) Mousse
 d) Extra Hold Styling Gel
 e) Bondo
 f) Spackle
 g) 40 Weight Oil
 h) Crazy Glue
 
 AUTOMOBILE OWNED:
 a) IROC Z
 b) Firebird
 c) Camaro
 d) Mustang
 e) Nova
 f) Chevette ( You got a f#%*ing problem with it?)
 
 NUMBER OF INCHES CAR IS OFF THE GROUND:
 a) 6-8 Inches    b) 4-6 Inches   c) 2-4 Inches    d) Under 2 Inches
 
 CHARACTERISTICS OF AUTOMOBILE:
 a) Gold chain around license plate
 b) Neon lights around license plate
 c) Neon lights under car
 d) Chippendales/Playboy air freshener hanging from rear view mirror
 e) Garter hanging from rear view mirror
 f) Chrome hubcaps
 g) Stick-on window tinting
 h) Stick-on paint splash stickers
 I) Fuzzy dice
 
 FAVORITE SPORTS TEAM:
 a) F#%*ing Devils
 b) F#%*ing Rangers
 c) F#%*ing Islanders
 
 FAVORITE MUSIC:
 a) Bruce Springstein
 b) Rap
 c) Bon Jovi
 d) Techno
 e) Bruce Springsteen