Plez compleet this paper, best ya can. Last name: ________________ First name: [_] Billy-Bob [_] Bobby-Sue [_] Billy-Joe [_] Bobby-Jo [_] Billy-Ray [_] Bobby-Ann [_] Billy-Sue [_] Bobby-Lee [_] Billy-Mae [_] Bobby-Ellen [_] Billy-Jack [_] Bobby-Beth Ann Sue Age: ____ (if unsure, guess) Sex: [_]M [_]F [_]None Shoe Size: ____ Left ____ Right Occupation: [_] Farmer [_] Mechanic [_] Hair Dresser [_] Waitress [_] Un-employed [_] Dirty Politician Spouse's Name: __________________________ 2nd Spouse's Name: __________________________ 3rd Spouse's Name: __________________________ Lover's Name: __________________________ 2nd Lover's Name: __________________________ Relationship with spouse: [_] 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: _______________________ Education: 1 2 3 4 (Circle highest grade completed) If you obtained a higher education what was your major? [_] 5th grade [_] 6th grade Do you [_] own or [_] rent your mobile home? 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 Age you started drivin ______ (If over 10 are you are still slow lerrnin ? [_] Yes [_] No) Firearms you own and where you keep them: ____ truck ____ kitchen ____ bedroom ____ bathroom/outhouse ____ shed ____ pawnshop Model and year of your pickup: _________ 194_ 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 [_] Bassmasters ___ 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 [_] Not Applicable How many teeth in YOUR mouth? ___ Color of teeth: [_] Yellow [_] Brownish-Yellow [_] Brown [_] Black [_] N/A Brand of chewing tobacco you prefer: [_] Red-Man [_] Skoal How far is your home from a paved road? [_] 1 mile [_] 2 miles [_] don't know How far is your home from a roadsign WITHOUT bulletholes ? [_] 1 state (or in the same state) [_] 2-5 states [_] 5 or more states How many diferent trucks does the parts in your truck come from? [_] 10 or less [_] 11-25 [_] 25-50 [_] 50 or more How many of the lamps on the truck's dashboard actually works? [_] None [_] 1-2 [_] Depends on the air humidity [_] All / most of them works, but they blink like a christmas tree

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