Name:________________ (first)
Name: ________________ (last)

(_) Billy-Bob
(_) Billy-Joe
(_) Billy-Ray
(_) Billy-Sue
(_) Billy-Mae
(_) Billy-Jack

(Check appropriate box)

Age: ____
Sex: ____ M _____ F _____ N/A
Shoe Size: ____ Left ____ Right

Previous Occupation:

(_)Hair Dresser

Spouse's Name: __________________________
Relationship with spouse:

(_) Sister
(_) Brother
(_) Aunt
(_) Uncle
(_) Cousin
(_) Mother
(_) Father
(_) Son
(_) Daughter

Number of children living in household: ___
Number 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)

___ 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
____ bedroom
____ bathroom
____ kitchen
____ shed

Model and year of your pickup: _____________ 194_

Newspapers/magazines you subscribe to:
(_)The National Enquirer
(_)The Globe
(_)TV Guide
(_)Soap Opera Digest

___ 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:
(_)Not Applicable

Color of teeth:

Brand of chewing tobacco you prefer:

How far is your home from a paved road?
(_)1 mile
(_)2 miles
(_)don't know


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Idiots in the Room

"If there are any idiots in the room, will they please stand up?" said the sarcastic teacher. After a long silence, one freshman rose to his feet. "Now then mister, why do you consider yourself an idiot?" enquired the teacher with a sneer. "Well, actually I don't," said the student, "but I hate to see you standing up there all by yourself."

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