APPLICATION FOR EMPLOYMENT
JESSE JACKSON'S STAFF

ADDRESS:  (If living in auto, give make, model and license number)
_________________________________________________________________

Yo' Momma's Name: _______________________________________________

Yo' Fava's Name:  _______________________________________________
                  (no more than three possible fava's)

1. AUTO: 
   Cadillac ___    Continental ___    Lincoln ___    Imperial ___
   Financed ___  Stolen ___  Other ______________________________

2. MARITAL STATUS: 
   Common Law ___  Shacked Up ___  Other ________

3. SOURCE(S) OF INCOME:   
   Theft ___ Relief ___ Welfare ___ Unemployment Compensation ___

4. PLACE OF BIRTH:  
   Charity Ward ___   Cotton Patch ___   Zoo ___   Back Alley ___
   Free Clinic ___  Other _______________________________________

5. HOW MANY WORDS CAN YOU JIVE PER MINUTE? ______________________

6. CHECK MACHINES YOU CAN OPERATE:
   Crowbar ___    Pinball ___   Boom Box ___   Straight Razor ___
   Trojan Dispenser ___ Other ___________________________________

7. FAVORITE FOODS: 
   Bar-B-Que ___  Carp ___  Coon ___  Catfish ___  Watermelon ___
   Chitlins ___  All of the above _______________________________

8. PRIOR EXPERIENCE:
   Govt. Worker ___   Black Panther ___  Pimp ___  Evangelist ___
   Rapist ___  Dope Dealer ___  Used Car Salesman ___

9. HOW MANY KNOWN CHILDREN DO YOU HAVE? 
   1st Wife ___ 2nd Wife ___  Neighbors Wife ___  Shack-Up's ___

10. IN 50 WORDS OR LESS STATE YOUR GREATEST DESIRE IN LIFE 
    (other than white women):  
    _____________________________________________________________
    _____________________________________________________________
    _____________________________________________________________

    IT IS NOT NECESSARY TO ATTACH PHOTO SINCE YOU ALL LOOK ALIKE.