[] Mr.    [] Mrs.    [] Miss    [] Dr.    [] Sir    [] His/Her Majesty [x] -sama
Name: (Last)_Amahira________(First)_One__________(Middle Initial) N/A
Alias(es): _Kaioshin no Miko______________
Age: _16______
Gender: [] None     [] Male     [x] Female     [] Other: ___________
Date of birth: 01/05/85
Marital status: [] Single     [] Married (Spouse's name: ___________________)
                      [x] Other: _Part of Kat's harem.
Height: 5' 2 1/2" Hair color: _Brown
Weight: 110-120  Eye color: _Blue_

Address:_#Reploid_Productions__
City: _dream.esper.net_________  Zip: _5555___________
State: _EsperNet_____________  Country: _IRC_________
Planet: _Earth_______________  Galaxy: _Milky Way____

Race/Species: (check one)
[x] Human     [] Namek     [] Saiya-jin
[] Other (Please describe): _____________________________________

Position applying for:
[] East Kaioushin     [] West Kaioushin     [] North Kaioushin
[] South Kaioushin   [] Dai Kaioushin        [x] Any currently available
(NOTE: One or more positions may presently be unavailable)

What religion do you follow? (Check one)
[] Christianity       [] Judaism      [] Shinto
[] Buddhism         [] Wicca        [] Roman/Greek Pagan
[] Egyptian Pagan [] None         [] Islam
[x] Other (Please describe) _Shimekian_____________________

Do you have any of the following? (Check all that apply)
[x] Self-serving goals
[] Desire to destroy everything
[] Inability to look at the “big picture”
[] Heart problems
[] Illness that may impair reaction, nervous response, vision, or hearing
[x] Extreme PMS or other mood altering complications
[] Obsessive compulsive disorders
[] Speech impediment
[x] Craving for revenge
[] Inability to cope with stress
[x] Delusions of grandeur
[] Habit of destroying planets for fun
[] Extreme greed
[x] Multiple personality disorder
 If checked, how many personalities? _4_____
  Please describe each:
1) _Real Me_____________________
2) _Miko Me____________________
3) _Fangirl Me__________________
4) _Chibi Me____________________
(NOTE: If more than four, please use the extra space on back of application.)

Level of education completed: _Still in High School_
Level of training completed: _Can't even fly_______

Family history: Has any one related to you attempted or succeeded at the following? (Check all that apply)
[] Conquering the world/universe       [x] Turning Super Saiya-jin
[x] Traveling through time                  [] Murdering a deity
[] Collecting dragonballs                    [] Destroying the world/universe
[] Planting evil trees                           [] Fusion of any variety
[] Saving the world/universe               [] Creating androids
[x] Using psychic powers                  [] Massacring entire races
[] Using dragonballs                          [] Other: ____________________

Family medical history: Does anyone in your family have or suffer from the following? (check all that apply)
[] Substance abuse            [x] Depression
[x] Cancer                        [x] Diabetes
[x] Insanity                        [x] Glaucoma
[x] Alcohol abuse              [] Heart problems
[x] Brain damage               [x] Extreme PMS
[] Anxeity disorders           [] Anemia
[] Turned to stone              [] Turned into a snack food
[] Other: ___________________________

What unusual abilities do you possess? (Check all that apply)
[] Telepathy                                 [] Ki manipulation
[] Mind reading                            [] Transformations
[] Flight without wings                  [] Power to heal
[] Magic                                      [] Pyrokinesis
[] Communication with the dead   [] Ultra-acute senses
[] Can change bodies                   [] Can see the future
[] Conjuring items                        [] Magic spit
[] Teleportation                            [] Manipulation of negative thoughts
[] Psychic powers                        [x] Other (Please describe): _Newtype Wannabe_
(NOTE: More space on back of application)

Do you take any mind-altering substances? [x] Yes [] No
 If yes, which ones? _Orthotricyclen_________
  How often? _Once a day_____________

Have you committed any felony in the past 1000 years? (Car theft, shoplifting, large-scale genocide, etc?) [] Yes     [x] No
 If yes, please describe: __________________________________________________
____________________________________________________________________
____________________________________________________________________

Please describe any previous experience(s) that you feel qualifies you for this position:
_Previous experiences? I don't think there is really anything that could qualify anyone
for such a position. However, I believe it has been proven on more than one occassion
That I am capable of remain calm in a crisis, and am able to help those around me.__

Please list your previous employment(s) and referrals: _I am currently employed as (East)
Kaioshin no Miko (maybe he'll give me a referral). I am also a High school student, a_
dog-walker, a webmistress, and 'security' for the Los Angeles Kart Club. At this time_
I have no referrals. I will however permit you to contact my employers and therapist._

If accepted, what are your goals as a Kaioushin? _I suppose that "glomping the East____
Kaioshin because he is kawaii" is not an acceptable answer. My goal is to rid the uni-_
verse of stupidity, since I don't believe world peace, let alone universal peace is possible.
I will answer all questions about this belief. ___________________________________

What do you think being a Kaioushin means? _Um... That I have to wear strange clothes
and odd earrings? ... Do I HAVE to wear something with poofy shoulders-?_________
_____________________________________________________________________
_____________________________________________________________________

What duties do you think a Kaioushin is required to perform? _Obviously watching over the
universe for several million years. I assume one would be required to watch for and eli-
minate threats to the universe and the 'big picture'. However, I believe it couldn't hurt_
to watch and take care of smaller things too. If you've got that kind of power, the least
you could do is use to do some good. (... Actually, watching over the universe or part of it for millions of years seems kind of boring. Another reason to just go out and do something.)

Thank you for completing this form. We will contact you if you are accepted. Remember, if accepted, the role of Kaioushin is a lifelong commitment full of exciting perks!

All accepted applicants will be required to take a full psychological evaluation, wear strange earrings and odd clothes. Earrings and clothes will be provided, as well as a thorough instruction session familiarizing applicants with the duties and powers of being a “God”.