Fill this out, and I may get back to you~!
Home
Application
Instructions: Please fill out application to the best of your ability. Then print it out and mail it to Jerry and wait for a reply.
 
First Name
Middle Name Last Name
 
E-mail
Facebook Yes No
 
Address
Zip Code
 
State
Country
 
Home Phone
Cell Phone
  What grade are you in? What school?
 

Qualifications:

Please tell me why you think you are qualified to be a Friend of Jerry.

 
  Do you meet the requirements? Yes No*
  If yes then please list what you would add the the group.
  How did you find out about Friends of Jerry?
  Do you know Jerry? Yes No**
  What is your history with Jerry?
  Are you a red head?
  You have this text box to persuade me to let you join this club. Be persuasive!!!
  Warning: If no reply comes in a month, then your application was voided, do not wait for a reply after a month because it will not be coming! Warning: Becoming a friend of jerry may cause several symptoms such as; uncontrollable smiling, maniacal laughter, an overwhelming feeling of accomplishment, jealousy from your friends, fits of jumping out of pure joy, a sudden explosion of self esteem, you may just have to call all your friends to tell them about it feelings, and in some rare occasions death from pure overwhelming happiness. You have been Warned!!!
 


I ___________________ have read the warnings and understand that by signing this application I cannot and will not hold Jeremiah Bechtold responsible for any terrible happenings that may occur if accepted or rejected.

Signature_____________________ Date____________

 
  All Fields are Required! *If you checked no then why are you still applying? **Then why are you even applying?