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 Shoe Size: ____ Left ____ RightOccupation:
[_] Farmer [_] Mechanic
[_] Hair Dresser [_] Waitress
[_] Un-employed [_] Dirty PoliticianSpouse's Name: __________________________
2nd Spouse's Name:___________________________
3rd Spouse's Name: __________________________Number of children living in household: ___
Number of children living in shed: ___Mother's Name: ___________________(include first and last)
Father's Name: ___________________(include first and last)Education: 1 2 3 4 (Circle highest grade completed)
If you obtained a higher education, what was your major?
[_] 5th grade [_] 6th gradeDo 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 blocksAge you started drivin ______
(If over 10 are you are still slow lerrnin? [_] Yes * [_] No)Firearms you own and where you keep them:
____ truck ____ kitchen ____# of firearms
____ bedroom ____ bathroom/outhouse
____ shed ____ pawnshopModel 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 UFOHow often do you bathe:
[_] Weekly
[_] Monthly
[_] Not ApplicableHow many teeth in YOUR mouth? ___
Color of teeth:
[_] Yellow [_] Brownish-Yellow
[_] Brown [_] Black
[_] N/ABrand of chewing tobacco you prefer:
[_] Red-Man [_] SkoalHow far is your home from a paved road?
[_] 1 mile
[_] 2 miles
[_] don't know