Single-Paragraph, Fill-in-the-Blanks
Personal Statements for Inclusion
With Applications for
[Major Life Opportunity].

with Rachel Summer Claire Friedman

I. Admission to College (Liberal Arts)

Most twelve-year-olds don’t dream of __________ [verb+ing] the __________ [plural noun] in __________ [developing country], but I did. While the other kids were spending their allowances on __________ [high-tech gadget], __________ [brand of junk food], and tickets to see __________ [wildly popular if only mildly talented musical act], I was saving mine for something more important. My friends teased me about my obsession, but I knew that my __________ [personal quality], desire to help the __________ [segment of population], and __________ [“high moral character”] would serve me better than buying into any fad. As it turned out, when I had finally saved up enough money, the international political climate was such that Americans are not allowed to make the trip I’d been looking forward to for so many years, but all the same I feel that the __________ [choose one: maturity/self-righteousness/financial freedom] I have gained was well worth the sacrifice.

II. Admission to Law School

Even before I was president of my junior high school’s __________ [non-athletic organization], I firmly believed that there ought to be more legislation regarding __________ [personal freedom guaranteed by the Constitution]. In high school, I successfully petitioned the administration to allow students to __________ [verb] in school, as long as they agreed to hold the school harmless for any injuries suffered during said activity. My undergraduate major of [choose one: English/Political Science/Undecided] has given me a profound appreciation for the importance of law in society, and my work during summers at my __________ [relative or family friend]’s law firm has enabled me to discover my own __________ [personal quality], desire to help the __________ [segment of population], and __________ [“high moral character”]. As a lawyer, I would strive to make __________ [place] a better place, through my [choose one: caring/determination/ruthless ambition].

III. Admission to Medical School

I have wanted to be a doctor since the age of __________ [number between 1 and 10], when [choose one: I/my parent/my grandma/my best friend] suddenly came down with __________ [life-threatening illness], forcing me to realize just how __________ [adjective] life is, and how __________ [adjective] proper diagnosis and treatment are. At age __________ [number between 11 and 15], volunteering at my __________ [relative or family friend]’s medical office enabled me to discover my own __________ [personal quality], desire to help the __________ [segment of population], and __________ [“high moral character”]. In college, which I started at age 16, in addition to my coursework in [choose one: Biology/Chemistry/Biochemistry/Spanish Literature], I have worked for __________ [number between 20 and 60] hours per week in __________ [renowned scientist]’s lab, studying the effects of __________ [experimental drug] on the __________ [body system] system of the __________ [small mammal] with __________ [incurable chronic disease]. As a doctor, I would strive to make __________ [place] a better place, through my [choose one: caring/determination/humility].

IV. United States Citizenship

I believe in the United States of America as a government of the people, by the people, for the people; whose just powers are derived from the consent of the governed, a democracy in a republic, a sovereign Nation of many sovereign States; a perfect union, one and inseparable; established upon those principles of freedom, equality, justice, and humanity for which American patriots sacrificed their lives and fortunes. I therefore believe it is my duty to my country to love it, to support its Constitution, to obey its laws to respect its flag, and to defend it against all enemies. If I am blessed with the matchless privilege that is United States citizenship, I will change my last name to __________ [brief, non-ethnic surname].

V. Title of Miss America

What good is being __ [bust circumference in inches]- __ [waist circumference in inches]- __ [hips circumference in inches], if you don’t give 110% of yourself toward making the world a better place? What good is having naturally __________ [color] hair, if you won’t try to unite people of all colors? What good is being able to __________ [talent] on national television, if there are children who can’t watch you because they have to work from morning to night every day, in factories, making athletic shoes, earning only pennies a week? As Miss America, I would do everything in my power to [choose three: feed the world/reverse global warming/convert the heathens/close the digital divide/cure cancer/eliminate domestic dependence on foreign oil].

VI. Child Adoption

After __________ [number] years of [choose one: boredom/professional success/complete irresponsibility] as a couple, and, more recently, __________ [amount of time] of [choose one: soul-searching/counsel from clergy/nagging from parents], my spouse and I decided that we would like nothing more than to raise a child. Unfortunately, we are unable to conceive due to [choose one: infertility/predisposition to congenital fetal abnormality/court order]. Spending __________ [amount of time] with __________ [relative or family friend]’s kids has enabled us to discover our own __________ [personal quality], desire to help the __________ [segment of population], and __________ [“high moral character”]. If possible, we would like to adopt a child from __________ [developing country]—the one we saw Brad and Angelina holding on the cover of __________ [tabloid] was just too cute!—but we will accept a baby from America, if need be. We know that we will be __________ [adjective] parents, and we will make sure that our child never wants for __________ [high-tech gadget], __________ [brand of junk food], or tickets to see __________ [wildly popular if only mildly talented musical act].

VII. Parole

In the __________ [amount of time] since I was last eligible for parole, I have been a model prisoner. I had nothing to do with the unfortunate incident in the __________ [location] on __________ [date], which was planned entirely by __________ [name of inmate(s)]. I do not approve of the smuggling of __________ [item(s)] into our facility by __________ [name of inmate(s)], nor of abuse of inmates by corrections personnel, of which I have seen none in the __________ [amount of time] I have served of my __________ [amount of time] after my deserved and unappealable conviction for __________ [felony]. Over the many hours I have spent in the prison library, reading books not about criminal law but instead about __________ [technical vocation], I discovered my own __________ [personal quality], desire to help the __________ [segment of population], and __________ [“high moral character”]. If granted early release, I would be a living, breathing, behaving testament to the __________ [virtue] of the American penal system and the usefulness of prayer.

Matthew David Brozik wrote this and many other short humor pieces, which have been published in print and online by The New Yorker, Adult Swim, McSweeney’s Internet Tendency, Grin & Tonic, The Big Jewel, and no one.

Read more humor here. Or read some fiction here.