1. House address: 2. Is this house on a farm (or ranch)? 3. If no in item 2: Is this house on a place of three or more acres?
For All Persons:
4. Name (last name first): Middleford, Elizabeth.
· What is the name of the head of household? Axel. · What are the names of all other persons who live here? · List in this order: - The head: Axel. - His wife: The Handmaid. - Unmarried sons and daughters and their families (in order of age): Elizabeth and a drone son. - Married sons and daughters and their families: There aren't any that I'm aware of. - Your least favorite color: Ohh, all colors are wonderful, but... I dislike wearing black. It's for only the saddest of occasions.
5. Species (underline applicable):
Human (H) Animal (A) Communist (☭) Wizard (W) Catgirl (CG) God/Goddess (G) Other (please specify)
6. Sex (underline applicable):
Male (M) Female (F)
7. Are you now married, widowed, divorced, separated, or never married? (Mar, Wd, D, Sep, Nev) Nev. I am engaged, however.
8. What State (or foreign country) were you born in? England, naturally.
9. What is your deepest secret? Until recently, it was my fencing skill. Now... I suppose it is my suspicions about Ciel's past.
10. If foreign born: Are you naturalized? (Yes, No, or AP for born abroad of American parents) Heavens, no!
11. What are you most ashamed about? Worrying that Ciel would no longer like me at all if he found out I could defend myself. It feels so very foolish now.
For Persons 14 Years of Age and Over:
12. What were you doing most of last week: working, keeping house, or something else? (Wk, H, Ot, or U for unable to work) H and Ot.
13. If H or Ot in Item 12: Did you do any work at all last week, not counting work around the house? (Include work for pay, in own business, profession, on farm, or unpaid family work) (Yes or No) No.
14. If No in Item 13: Were you looking for work? (Yes or No) No.
15. If No in Item 14: Even though you didn't work last week, do you have a job or business? (Yes or No) No.
16. If No in Item 15: Do you have a good explanation for why you are being so utterly useless to the prosperity of our great town? (Yes, Female, or No, elaborate. Yes is not a valid answer.) No. I hadn't considered working before, but... I believe I should! This is the modern era, after all! Mother would be scandalized to learn I haven't been doing my very best to adapt and learn while I am here.
For All Persons:
17. What country were your father and mother born in? (Enter US or name of Territory, possession, or foreign country)
Father:My father, Alexis, is a proud Englishman. Mister Axel, on the other hand... I haven't the faintest idea! Mother: My mother, Frances, was born and raised in England, as well. The Handmaid is a mystery to me, unfortunately.
18. If anything but America in Item 17, justify your right to be here (maximum 100 words):
19. What is your most embarrassing memory? Well, I suppose it must be my reaction after the dust settled after my battle on the Campania. I actually burst into tears in front of Ciel over something like that! I even offered to carry him on my back! Can you believe it? How unladylike of me. It's so horribly embarrassing, after the fact.
20. What is more important- laughter (L) or medicine (M)? L!
21. Please list all of the following diseases you have been afflicted by, if any: Measles (M), Mumps (U), Chicken-Pox (C), Polio (P), Tuberculosis (T), Smallpox (S), Communism (R) C, M
For All Males in the Household:
22. Did you ever serve in the U.S. Armed Forces during (specify Y or N):
22a. World War II
22b. World War I
22c. Any other time, including present service
23. If No to any question in Item 22, justify your reasons for being so reprehensibly unpatriotic (maximum 100 words):
24. Are you a Communist? Are you?
For All Persons:
25. Is there an afterlife and how do you know this isn't it? (maximum 100 words) If this were Heaven, I truly am disapointed. There are hardly any angels anywhere! And where is God and Jesus? If this is Hell, I don't believe it's trying nearly hard enough to punish us. Besides, I haven't done anything to deserve Hell!
no subject
1. House address:
2. Is this house on a farm (or ranch)?
3. If no in item 2: Is this house on a place of three or more acres?
For All Persons:
4. Name (last name first): Middleford, Elizabeth.
5. Species (underline applicable):
6. Sex (underline applicable):
7. Are you now married, widowed, divorced, separated, or never married? (Mar, Wd, D, Sep, Nev) Nev. I am engaged, however.
8. What State (or foreign country) were you born in? England, naturally.
9. What is your deepest secret? Until recently, it was my fencing skill. Now... I suppose it is my suspicions about Ciel's past.
10. If foreign born: Are you naturalized? (Yes, No, or AP for born abroad of American parents) Heavens, no!
11. What are you most ashamed about? Worrying that Ciel would no longer like me at all if he found out I could defend myself. It feels so very foolish now.
For Persons 14 Years of Age and Over:
12. What were you doing most of last week: working, keeping house, or something else? (Wk, H, Ot, or U for unable to work) H and Ot.
13. If H or Ot in Item 12: Did you do any work at all last week, not counting work around the house? (Include work for pay, in own business, profession, on farm, or unpaid family work) (Yes or No) No.
14. If No in Item 13: Were you looking for work? (Yes or No) No.
15. If No in Item 14: Even though you didn't work last week, do you have a job or business? (Yes or No) No.
16. If No in Item 15: Do you have a good explanation for why you are being so utterly useless to the prosperity of our great town? (Yes, Female, or No, elaborate. Yes is not a valid answer.) No. I hadn't considered working before, but... I believe I should! This is the modern era, after all! Mother would be scandalized to learn I haven't been doing my very best to adapt and learn while I am here.
For All Persons:
17. What country were your father and mother born in? (Enter US or name of Territory, possession, or foreign country)
18. If anything but America in Item 17, justify your right to be here (maximum 100 words):
19. What is your most embarrassing memory? Well, I suppose it must be my reaction after the dust settled after my battle on the Campania. I actually burst into tears in front of Ciel over something like that! I even offered to carry him on my back! Can you believe it? How unladylike of me. It's so horribly embarrassing, after the fact.
20. What is more important- laughter (L) or medicine (M)? L!
21. Please list all of the following diseases you have been afflicted by, if any: Measles (M), Mumps (U), Chicken-Pox (C), Polio (P), Tuberculosis (T), Smallpox (S), Communism (R) C, M
For All Males in the Household:
22. Did you ever serve in the U.S. Armed Forces during (specify Y or N):
23. If No to any question in Item 22, justify your reasons for being so reprehensibly unpatriotic (maximum 100 words):
24. Are you a Communist? Are you?
For All Persons:
25. Is there an afterlife and how do you know this isn't it? (maximum 100 words) If this were Heaven, I truly am disapointed. There are hardly any angels anywhere! And where is God and Jesus? If this is Hell, I don't believe it's trying nearly hard enough to punish us. Besides, I haven't done anything to deserve Hell!