Application
| Last Name:_________________________________ If unsure, guess |
| First Name: Check as
many as apply
[ ] Billy-Bob [ ]
Billy-Joe [ ] Billy-Ray [ ]
Billy-Sue [ ] Billy-Mae [ ]
Billy-Jack [ ] Billy-Bud
[ ] Bobby-Sue [ ] Bobby-Jo [ ] Bobby-Ann [ ] Bobby-Lee [ ] Bobby-Ellen [ ] Bobby-Beth Ann Sue |
| Age:_____ If unsure, guess |
| Sex: [ ] M [ ] F [ ] Not sure |
| Shoe Size: Left ______ Right ______ |
| Occupation: Check as
many as apply
[ ] Farmer [ ] Hair
Dresser [ ] Unemployed [ ]
Mechanic [ ] Waitress [ ] Dirty
Politician
|
| Spouse's Name:___________________________
2nd Spouse's Name:___________________________ 3rd Spouse's Name:___________________________ Spell S-P-O-U-S-E___________________________ |
| Relationship with
spouse: Check as many as apply
[ ] Sister [ ]
Aunt [ ] Brother [ ]
Uncle [ ] Mother [ ] Son [ ]
Father [ ] Daughter [ ]
Cousin [ ] Pet
|
| Number of children living in household:______
Number of children living in shed:______ Number of children that are yours:______ |
| Mother's
Name:__________________________ Father's Name:__________________________ If not sure, leave blank |
| Education: 1 2 3 4 5 6 7 Circle highest grade completed |
| Do you: [ ] Own [ ] Rent Your mobile home? Check appropriate box |
| Vehicles you own and where you keep
them: Total number of vehicles you own ______
Number of vehicles that still crank ______ Number of vehicles in front yard ______ Number of vehicles in back yard ______ Number of vehicles on cement blocks ______ |
| Firearms you own and where you
keep them:
Truck ______ Kitchen
______ Bedroom ______ Bathroom ______ Shed
______ Living room ______
|
| Model and year of your pickup:__________________ 196______ |
| Do you have a gun rack? [ ]
Yes [ ] No If no, please explain:________________________________________ |
| Newspapers/magazines you
subscribe to:
[ ] The National
Enquirer [ ] The Globe [ ] TV
Guide [ ] Soap Opera Digest [ ] Rifle and
Shotgun [ ] Armed and Ready!
|
| Number of times you've seen a UFO ______
Number of times you've seen Elvis ______ Number of times you've seen Elvis in a UFO ______ |
| How often do you bathe: [ ] Weekly [ ] Monthly [ ] Yearly [ ] N/A |
| How many teeth? ______ Color of teeth: [ ] Yellow [ ] Brownish-Yellow [ ] Green [ ] Brown [ ] Black [ ] N/A |
| Brand of chewing tobacco you prefer: [ ] Skoal [ ] Red-Man [ ] Copenhagen |
| How far is your home from a paved road? [ ] 1 mile [ ] 2 miles [ ] Over 2 miles [ ] What's a paved road? |
| Signature:
______________________________________________ ______________________________________________ |