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Jerry Springer Guest Application


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Personal Information:

Name___________ Nickname______________ CB Handle___________

Yore Mama______________ Yore Daddy (if known)________________

Spouse's Name_________________

Relationship to spouse:

___Sister ____Brother ____Mother ____Father ___Pet ___Aunt ___Uncle


___Unemployed Mechanic ___Gun Show Dealer ___Skinhead

Number of Children in Household___ Number that are yours___

Circle Highest Level of Education: 1 2 3 4

How Far is Your Mobile Home From a Paved Road:

___1mi. __5 mi. ___?

Number of Times You Have Survived a Tornado: ___

Number of Vehicles Owned___ Number on Cement Blocks___

Truck Equipment: ___Gun Rack ___Pit Bull ___Spit Cup ___Fuzzy Dice

___Rebel Flag ___Naked Woman Mudflaps ___NWO and/or NRA sticker

Weapons Owned: ___Tire Iron ___Pick Handle ___Beer Bottle ___Shotgun

Number of Dogs Owned: ___ Number of Homemade Tattoos: ___

Which of the Following Appliances are in your Front Yard:

___Friggerator ___Heatin Stove ___Warsher ___TV ___Freezer

How Many of the Above Appliances Work: ___

Fav-o-rite Recreation: ___Drinkin ___Cow Chip Throwin

___Possum Huntin ___Crawdad Huntin ___Spittin Backy

___Scratchin ___Watchin Wrasslin

If You Can Read, Which Magazines Do You Prefer:

___Soap Opera Digest ___True Confessions

___Rifle and Shotgun ___TV Guide ___National Enquirer

Which Stinks Worse: ___Hogpen ___Outhouse ___Spouse

Can You Spell Your Last Name: ___Yup ___Nope

Can You Remember Your Last Name: ___Yup ___Nope

Have You Ever Stayed Sober for More Than One Day: ___Yup ___Nope

Do You Know Any Words with More Than 4 Letters: ___Yup ___Nope

Which is Correct?: ___"I Seed Him" or ___"I Seen Him"

How Many Cartons of Cigarettes Do You Smoke a Day? ___

Math Test: How Many Food Stamps Do the Following Cost?

___Six Pack ___Ciggies ___Shotgun Shells ___Backy ___Prostitute

Number of Times You've Seen: ___a UFO ___ Elvis ___Elvis in a UFO

Health Questionnaire: Which of the Following Do You Have?

___Head Lice ___B.O. ___Crabs ___Runny Nose ___Boils

Can You Remember the Last Time You Bathed? ___Yup ___Nope

Color of Teeth: ___Yellow ___Brown ___Black ___N/A

I hereby swear this is the trooth and sign my "X" on


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Okay, Ann, I'm under house arrest and have been channel surfing during the day. Every now and then, Springer comes into view and what I'd like to know is WHERE it says on the application that you'll be sittin' on stage in your underwear? For the life of me, I do not understand why someone would not remember that their tighty-whities are neither tight nor white!

Whassupwithat?? Every time the channel flips to Jerry, there are some nasty looking people sitting around in some nastier looking underwear and fightin' the sister who is sleeping with their man (or the brother who is!). Huh?

...and the audience! How hostile! "You, the fat guy on the left, why would she want to be with you? HE has all HIS teeth!" (Or whatever...)

Ahhhh, freedom of the press and freedom of speech. My ancestors died for this crap? :roll:

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