I General Social Data
Your name? Wife’s given and maiden name? Husband’s given name? Full names of children? Names of all other members of the household, and their relation to you? Unmarried, childless; only real familial note is that I’m a descendant of Elvira Madigan, upon whom a very boring Swedish film was based in 1967, and which information sometimes excites people over 60, particularly Europeans.

II Physical and Mental Conditions
Is the importance of regular sleep, bathing, care of the teeth, and regular action of the bowels appreciated? I have a strong and abiding affection for all the hygienical arts.

III Industrial History
What was your work record at these places for speed, accuracy, regularity, sobriety? Longstanding writer, producer, and editor of written works in a variety of formats and venues. Won a Daytime Emmy for writing on Cash Cab. Suffer occasional lapses into sobriety.

IV Education
What was the education of each worker in your family? Did you have any vocational training? Graduated Harvard in 2001, undertook vocational training at the European Film College in Denmark 2003-04.