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CA Residency Application ...


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No offense California friends...just had to share this.

Like, A Totally California State Residency Application... man...


(Feel free to use popular nicknames, such as "Moon Beam", "Dweezil", "Moon Unit" "Capt. Trips", etc.)

Age: _____________

Inner Child's Age: _______

Age in Dog Years: _______

Age as told to you in a vision by ancient Mayan calendar: ________


_____ M _____ F

_____ Hermaphrodite

_____ Still working it out in therapy

Footwear: ____ Birkenstocks ____ Barefoot

Condition of Feet:

____ Wash Daily ____ Wash Weekly

____ Like, whenever I get to the beach, man...


___ Massage Therapist

___ Astral Counsel

___ Pet Psychologist

___ Channeler of the Dead (real dead, not merely Grateful)

___ Follower of the Dead, (Grateful)

___ Tie-dye vendor at Dead Shows

___ Vendor of "nice hot, fresh veggie burritos" at concerts

___ Cooking up a scheme to channel Jerry Garcia

___ Assistant to Shirley MacLaine

___ Rent-A-Mob protester

___ Purveyor of Fine Herbal Remedies

___ Panhandler claiming to be a veteran

___ Professional Guest on Ricki Lake

___ LA rock star groupie

___ Bottom-feeding LA lawyer

___ Professional Emotional Victim

Name(s) of Significant Other(s):


Relationship(s) of Significant Other(s):

: ____ Astral Soulmate

____ One-night stand from the protest rally who stayed because the rent was cheap

____ My dog's massage therapist

____ "Just Friends"

____ They're really not that significant, but I'll try to claim them as tax deduction(s)

Number of Children in Commune: _____

Number of Inner Children In Commune: _____

Number of your Inner Children which have been molested by one of

Roseanne's multiple personalities: ____

Mother's Name: ____________________

Father's Name: ____________________

Where were you were conceived:

____ Woodstock

____ Monterey

____ Under the stars on in the commune's hot tub

____ In the back of a VW micro-bus on the way to a Dead show

Name of book exposing your parents as inner-child abusers:

Number of copies sold: ____

Number of Wind Chimes Owned: ____

Number of times you've given yourself a concussion by hitting head on wind chimes: ___

Number of time you've channeled dead space aliens: ____

Number of times a space alien has copped a feel off you: ____

Talk Shows on Which You Make a Regular Appearance:

____ Donahue ____ Ricki Lake ____ Geraldo ____ Sally Jesse ____ The morning news' surf report

Number of times you've eaten your surfboard: ____

Above, while still in parking lot after tripping on your sandals: ____

Number of Grateful Dead concerts attended: ____ (if all, enter "on tour")

Number of bongs you own: ____

Number of times you've drunk your bong water because the weed ran out:

Political Party Affiliation: (Choose as many as you have personalities)

____ Green Party

____ American Communist Party

____ Socialist Party

____ New Age Astral Party (channeling the spirits of dead Romans)

____ Hemp Party

____ The Party-Hearty Party

____ Inner Child Abuse Hotline Party

____ New Age Goddess Party

How far is your home from the waterline:

___ Miles

___ Yards

___ Feet

___ I like to wake up with sand in my nose and seaweed in my teeth, in true harmony with nature as it washes up my nose

Number of surfboards owned: ____

Number of seconds you can talk without using the words "totally", "like", "man" and "fer shure": ____ (enter, like 0, if you, like, totally don't know)

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