GREATER LOS ANGELES AREA DRIVER'S LICENSE APPLICATION:
Name:___________________
Stage name: ____________________
Agent:___________________
Attorney:_______________________
Therapist name:_________________
Sex: ___male ____ female ____formerly male
_____formerly female ____both
*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 ___
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: [ ] Red [ ] Orange [ ] Green [ ] Purple
[ ] Blue [ ] Skinhead
Please check activities you perform while driving:
(Check all that apply)
[ ] Eating
[ ] Drinking Starbucks coffee
[ ] Applying make-up
[ ] Shaving (male or female)
[ ] Talking on the phone
[ ] Slapping kids in the back-seat
[ ] Applying cellulite treatment to thighs
[ ] Tanning
[X] Snorting cocaine (already checked for your
convenience)
[ ] Watching TV
[ ] Reading Variety
[ ] Surfing the net via laptop
[ ] Discharging firearms / Reloading
Please indicate how many times
a) you expect to shoot at other drivers _____
b) how many times you expect to be shot at while
driving _____
If you are the victim of a carjacking, you should
immediately:
a) Call the police to report the crime.
b) Call KCAL Channel 9 News to report the crime, then
watch your car on the news in a high-speed chase.
c) Call your attorney and discuss lawsuit against
cellular phone company for 911 call not going
through.
d) Call your therapist.
In the event of an earthquake, you would
a) stop your car
b) keep driving and hope for the best.
c) immediately use your cell phone to call all loved
ones.
d) pull out your video camera and obtain footage for
Channel 9.
In the instance of rain, you should:
a) Never drive over 5 MPH.
b) Drive twice as fast as usual.
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?
a) Prozac
b) Zovirax
c) Lithium
d) Zanax
e) Valium
f) Zoloft
g) All of the above
h) None of the above
*If none, please explain: __________________.
Length of daily commute:
a) Less than 1 hour
b) 1 hour
c) 2 hours
d) 3 hours or more
* If less than 1 hour, please explain:
______________.
When stopped by police, you should:
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 Freeway.
c) Have your video camera ready and provoke them to
attack, thus ensuring yourself of a hefty lawsuit.
When turning, you should always signal your
intentions
by:
a) using your directional signals.
b) What is a "directional signal"?
Which part of your car will wear out most often?
a) the horn
b) the horn
c) the horn
The "bright" setting on your headlights is for:
a) dark, poorly lit roads
b) flashing to get the car ahead to move out of the
way
c) revenge!
Your rear view mirror is for:
a) watching for approaching cars
b) watching for approaching police cars
c) checking your hair
Name:___________________
Stage name: ____________________
Agent:___________________
Attorney:_______________________
Therapist name:_________________
Sex: ___male ____ female ____formerly male
_____formerly female ____both
*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 ___
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: [ ] Red [ ] Orange [ ] Green [ ] Purple
[ ] Blue [ ] Skinhead
Please check activities you perform while driving:
(Check all that apply)
[ ] Eating
[ ] Drinking Starbucks coffee
[ ] Applying make-up
[ ] Shaving (male or female)
[ ] Talking on the phone
[ ] Slapping kids in the back-seat
[ ] Applying cellulite treatment to thighs
[ ] Tanning
[X] Snorting cocaine (already checked for your
convenience)
[ ] Watching TV
[ ] Reading Variety
[ ] Surfing the net via laptop
[ ] Discharging firearms / Reloading
Please indicate how many times
a) you expect to shoot at other drivers _____
b) how many times you expect to be shot at while
driving _____
If you are the victim of a carjacking, you should
immediately:
a) Call the police to report the crime.
b) Call KCAL Channel 9 News to report the crime, then
watch your car on the news in a high-speed chase.
c) Call your attorney and discuss lawsuit against
cellular phone company for 911 call not going
through.
d) Call your therapist.
In the event of an earthquake, you would
a) stop your car
b) keep driving and hope for the best.
c) immediately use your cell phone to call all loved
ones.
d) pull out your video camera and obtain footage for
Channel 9.
In the instance of rain, you should:
a) Never drive over 5 MPH.
b) Drive twice as fast as usual.
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?
a) Prozac
b) Zovirax
c) Lithium
d) Zanax
e) Valium
f) Zoloft
g) All of the above
h) None of the above
*If none, please explain: __________________.
Length of daily commute:
a) Less than 1 hour
b) 1 hour
c) 2 hours
d) 3 hours or more
* If less than 1 hour, please explain:
______________.
When stopped by police, you should:
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 Freeway.
c) Have your video camera ready and provoke them to
attack, thus ensuring yourself of a hefty lawsuit.
When turning, you should always signal your
intentions
by:
a) using your directional signals.
b) What is a "directional signal"?
Which part of your car will wear out most often?
a) the horn
b) the horn
c) the horn
The "bright" setting on your headlights is for:
a) dark, poorly lit roads
b) flashing to get the car ahead to move out of the
way
c) revenge!
Your rear view mirror is for:
a) watching for approaching cars
b) watching for approaching police cars
c) checking your hair
