DR. STEVE-O APPLICATION

Answer all questions honestly and to the best of your ability.

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MONTH OF BIRTH: January February March April May June July August September October November December DAY OF BIRTH: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YEAR OF BIRTH: DAYTIME PHONE EVENING PHONE MOBILE PHONE / PAGER 1. DO YOU CONSIDER YOUR LIFE BORING? 2. WHY? WHAT WOULD YOU DO TO IMPROVE YOUR LIFE AND LIVE IT TO THE FULLEST? 3. DESCRIBE YOUR MOST EMBARRASSING MOMENT EVER: 4. HOW WOULD SOMEONE WHO KNOWS YOU DESCRIBE YOUR BEST TRAITS? 5. HOW WOULD SOMEONE WHO KNOWS YOU DESCRIBE YOUR WORST TRAITS? 6. WHY DO YOU NEED DR. STEVE-O'S HELP? BE SPECIFIC. 7. IF THERE WERE ONE THING ABOUT YOURSELF THAT YOU COULD CHANGE, WHAT WOULD IT BE? PLEASE UPLOAD TWO RECENT PICTURES