Name __________________

Age __________________ (Do you want to stop here?)

Are you better known as a solo act or with a group? __________________

If with a group, how many surviving members are there? __________________

Of those who are no longer living, how many died of natural causes? __________________

Of those who are still living, how many look like Keith Richards? __________________

Expected demographic of audience: (Check all that apply)

  • People who want to relive the days of peace and love
  • People who think it’s still the days of peace and love
  • People who are only aware of your music because corporate rock radio

    stations have drilled your songs into their head by overplaying them

  • People unprepared for the utter parody of rebellion you’ve become

I am best known for: (Check all that apply)

  • A hit song
  • A hit album
  • Covering up my lack of talent with wild stage extravagances
  • Spandex Clothing
  • Surviving intake of lethal amounts of drugs
  • Being held responsible for the suicides of teens I’ve never met

Pick the comeback tour slogan that’s right for you:

  1. Withered Bones
  2. Shadows of the Past
  3. The Ultimate Grouch
  4. One Foot in the Grave
  5. Steel Dentures

Please check the last type of venue you played in:

  • Stadium with capacity of 20,000 or more
  • Stadium with capacity of 10,000 or more
  • Stadium with capacity of 1,000 or more
  • Buddy’s Picnic
  • VFW Hall
  • Bowling Alley
  • Garage
  • Basement

What year did you originally start playing your instrument? __________________

Did you ever learn how to play it? Yes or No

Tell us about what you’ve been doing since leaving rock and roll.

  • Living in bitter regret that I chose to go solo then flopped miserably
  • Doing walk-ons on bad sitcoms
  • Hiding out in Africa with Elvis
  • Choosing the right moment to unleash a tired, bombastic new album

I currently subscribe to the following magazines: (Check all that apply)

  • Rolling Stone
  • Melody Maker
  • Billboard
  • NME
  • Modern Maturity

If my application is accepted, I would like the following on-stage apparatus at any concert I may perform: (Check all that apply)

  • Flame-Throwers
  • A Rotating Stage
  • A Guillotine
  • Giant Inflatable Genitalia
  • A Wheel Chair
  • A Hearing Aid

Do you still abuse drugs? Yes or No

Does someone have to help you? Yes or No

Stage wear you would require: (Check all that apply)

  • Jeans/T-shirt
  • Glittery robes
  • Imported Italian shirts
  • “Depends”

Enter the number of your songs automobile companies now use to shill their product __________________

Enter the number of auto companies you would like to use your song to shill their product __________________

Check any of the following that might impair or inhibit your stage performance:

  • Bright flashing lights
  • Loud exploding charges
  • Stage Divers
  • Projectiles thrown by the audience
  • Being onstage with grudge-holding, ego-obsessed bandmates

Please indicate your primary motivation for wanting to rejoin the rock world:

  • To put my children through college
  • To pay off the I.R.S. for owed back taxes
  • Blew all my money on drugs and/or unsound investments

Are you willing to “unplug” for an acoustic set? Yes or No

Are you willing to “unplug” your notions of being sexually attractive over the age of 50? Yes or No

Will you require assistance to smash your equipment at the end of a set? Yes or No

Think back to your younger years.

Recall the rebellion you embodied, the incredible talent you possessed, the dedicated fan base you had.

Are you willing to trade all of that in for some quick cash? Yes or No

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