Bad Drivers of LA Unite!
Sex: [ ] male [ ] female [ ] formerly male [ ] formerly female [ ] both
*If female, indicate breast implant size: _______
Will size of implants hinder your ability to safely operate a motor vehicle in any way? [ ] Yes [ ] No
Please list brand of cell phone: _____________.
*If you don't own a cell phone, please explain:___________________________.
Please check hair color:
Females: [ ] Blonde [ ] Platinum Blonde
Teenagers: [ ] Red [ ] Orange [ ] Green [ ] Purple [ ] Blue [ ] Skinhead
Please check activities you perform while driving: (Check all that apply)
[ ] Eating
[ ] Drinking Starbucks coffee
[ ] Applying make-up
[ ] Shaving (male or female)
[ ] Talking on the phone
[ ] Slapping kids in the back-seat
[ ] Applying cellulite treatment to thighs
[ ] Tanning
[X] Snorting cocaine (already checked for your convenience)
[ ] Watching TV
[ ] Reading Variety
[ ] Surfing the net via laptop
[ ] Discharging firearms / Reloading
Please indicate how many times
a) you expect to shoot at other drivers _____
b) how many times you expect to be shot at while driving _____
If you are the victim of a carjacking, you should immediately:
[ ] Call the police to report the crime.
[ ] Call KCAL Channel 9 News to report the crime, then watch your car on the news in a high-speed chase.
[ ] Call your attorney to discuss lawsuit against cellular phone company for 911 call not going through.
[ ] Call your therapist.
In the event of an earthquake, you should:
[ ] stop your car.
[ ] keep driving and hope for the best.
[ ] immediately use your cell phone to call all loved ones.
[ ] pull out your video camera and obtain footage for Channel 9.
In the instance of rain, you should:
[ ] never drive over 5 MPH.
[ ] drive twice as fast as usual.
[ ] you're not sure what "rain" is.
Please indicate number of therapy sessions per week: ______.
Are you presently taking any of the following medications?
[ ] Prozac
[ ] Zovirax
[ ] Lithium
[ ] Zanax
[ ] Valium
[ ] Zoloft
[ ] All of the above
[ ] None of the above If none, please explain: __________________.
Length of daily commute:
[ ] Less than 1 hour *
[ ] 1 hour
[ ] 2 hours
[ ] 3 hours or more
* If less than 1 hour, please explain: __________________________.
When stopped by police, you should:
[ ] pull over and have your driver license and insurance form ready.
[ ] try to outrun them by driving the wrong way on the 405 Freeway.
[ ] have video camera ready and provoke them to attack, thus ensuring yourself of a hefty lawsuit.
When turning, you should always signal your intentions by:
[ ] using your directional signals.
[ ] what is a "directional signal"?
Which part of your car will wear out most often?
[ ] the horn
[ ] the horn
[ ] the horn
The "bright" setting on your headlights is for:
[ ] dark, poorly lit roads
[ ] flashing to get the car ahead to move out of the way
[ ] revenge!
Your rear view mirror is for:
[ ] watching for approaching cars
[ ] watching for approaching police cars
[ ] checking your hair