ARE YOU AN ASSHOLE? WE WANT TO KNOW!

HELP US CREATE A PROPER ASSHOLE DATABASE. PLEASE FILL OUT THIS MESSAGE FORM BELOW WITH AS MUCH OF YOUR CONTACT INFORMATION AS YOU FEEL COMFORTABLE PROVIDING (EMAIL, ADDRESS, PHONE #, ETC). AS WELL AS YOUR ASSHOLE ASSOCIATION NUMBER. IF YOU HAVE YOUR CARD OR CERTIFICATE, YOU CAN ALSO ATTACH A COPY.