RED NECK DRIVER'S LICENSE APPLICATION

(Folks from Mississippi and Louisiana, please use the form with pictures)

? Last name: ________________

(Check appropriate box)

? First 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 _____ Not sure

? 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: ________________________ (If not sure, leave blank)

? Education: 1 2 3 4 (Circle highest grade completed)

? Do you [_] own or [_] 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

? 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

___ 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? ___

? Colour of teeth:

[_] Yellow [_] Brownish-Yellow
[_] Brown [_] Black
[_] N/A

? Brand of chewing tobacco you prefer:

[_] Red-Man

? How far is your home from a paved road?

[_] 1 mile
[_] 2 miles
[_] don't know

? PLEASE MAKE YOUR MARK HERE: ______________________