Application Form for Women Candidates under Women's Reservation Bill

1. Personal irrelevant details:
   1. Name (as you would like it to appear in the ballot paper):
   2. Age (as you appear to yourself in your mirror) :
   3. Father’s name (if known) :
   4. Marital Status:  Single/Separated/In a relationship/married  [Please tick one]
   5. If single/in a relationship are you planning to be married? Yes/No
   6. If separated/married will you get divorced, eventually? Yes/No
   7. If separated/married number of children:  a) Daughters:       B) Sons:
   8. Did you determine the sex of your baby before you delivered them? Yes/No
   9. Are you self-employed/employed/good-for-nothing housewife?  [Please tick one]

• a) If self-employed what do you do? (Attach separate sheet of paper and write briefly in 10,000 words)

• b) If employed, have you been sexually discriminated against at your work place? Yes/No. (If yes, attach   separate sheet of paper giving complete description in not less than 100,000 words)

• c) If you are a good-for-nothing housewife how many times in a day do you:

• • 1. Gossip with neighbours
    2. Scrap with your servant maids
    3. Watch re-runs of yesterdays serials
    4. Do make-up and change your dress
    5. Help your children with their home work
    6. Make elaborate plans about topics to fight with your husband

2. Personal relevant details:
   1. What is your education level? Literate/Illiterate [Tick one]
   2. Have you ever been a leader in your neighbourhood? [Yes/No]

• • 1. If yes, was it winning catfights at the public water tap/ration shop? [Tick one]
    2. If no, please provide details in a separate sheet of paper in not less than 100 words, not including unparliamentary language.
    3. Have you taken part in instant sit-ins/gheraos/agitations? Yes/No [Tick one]
• 3. Has your husband/live-in/boy friend ever [Tick as many as applicable]

• • 1. Glared at you in anger
    2. Hit you in anger
    3. Threatened to hit you in anger
    4. Refused to cook for you
    5. Refused to wash dishes/clothes/mop the house
    6. Others (Please use separate sheets detailing the refusals]

• 4.  Have you ever refused sex to your husband/live-in/boy friend by stating that [Please tick   as many as applicable]

• • 1. you have a head-ache
    2. you have a stomach ache
    3. you have pre-menstrual cramps
    4. post-menstrual cramps
    5. not in the mood.

• 5. Has your husband/live-in/boy friend two-timed you by sleeping with [Please tick as many as applicable including number of times]

• • 1. the servant maid
    2. your best friend
    3. his secretary
    4. your best friend’s husband

• 6. Have you two-timed your husband/live-in/boy friend by sleeping with [Please tick as many as applicable including number of times]

• • 1. the courier man
    2. the postman
    3. the newspaper boy on the doorstep
    4. his best friend
    5. his best friend’s wife

• 7.  Have you ever [Tick as many as possible]

• • 1. Glared at your husband/live-in/boyfriend in anger?
    2. Hit your husband/live-in/boyfriend in anger?
    3. Threatened to hit your husband/live-in/boyfriend in anger?
    4. Refused to cook for your husband/live-in/boyfriend in anger?
    5. Thrown pots/pans at your husband/live-in/boyfriend in anger?
    6. Others [Please use separate sheets detailing the refusals]

Section 2

• 1. Irrelevant Public Record
     1. How many pairs of footwear do you own?
     2. How many saris do you own?
     3. How many kilos of gold/silver do you own?
     4. How many acres of agricultural land do you own?
     5. How many sets of Victoria’s Secret do you own?
     6. How many cars do you own?
     7. How many sets of ‘western/modern’ dresses do you own?
     8. How many houses/apartments do you own?
     9. How many pets do you own?
     10. How many times have you brought your home squabbles to the street?

• 2. Relevant Public Record:
     1. How many times have you been taken to the police station after 6pm?
     2. Do you support the brothels in your area?
     3. How many brothels would you like to run?
     4. Have you ever imbibed intoxicating substances like alcohol etc?
     5. Are you ready to throw objects at the Chair in Parliament/Assembly?
     6. Are you ready to lift your sari and show your nether regions to the media as a form of protest? [AIADMK women need not answer this for they have already done this]
     7. Are you mentally tough to beat the living shits out of the male MPs /MLAs who interrupt you?
     8. Are you mentally tough to manhandle the male MPs/MLAs outside Parliament/Assembly?
     9. Are you ready to change your party loyalty at a whim?