[Boofo]

Plez compleet this paper, best ya can.

Last name: ________________

First name:
[_] Billy-Bob
[_] Billy-Joe
[_] Billy-Ray
[_] Billy-Jack
[_] Bubba

Age: ____ (if unsure, guess)

Sex: [_]M [_]F [_]None

Shoe Size: ____ Left ____ Right

Occupation:
[_] Farmer [_] Mechanic
[_] Janitor [_] Still Operator
[_] Un-employed

Spouse's Name: ______________________________
2nd Spouse's Name: __________________________
3rd Spouse's Name: __________________________
Lover's Name: _______________________________
2nd Lover's Name: ____________________________

Relationship with spouse:
[_] Sister
[_] Aunt
[_] Mother
[_] Cousin
[_] Daughter
[_] Pet

Number of children living in household: ___
Number of children living in shed: ___
Number of children that are yours: ___

Mama's Name: ____________________
Daddy'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
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_ 195_ 196_ 197_

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
[_] Guns and Ammo [_] 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 or snuff you prefer:
[_] Red-Man [_] Skoal
[_] Levi-Garrett [_] Copenhagen
[_] Days Work [_] Garrett Sweet Snuff
[_] Cannon Ball

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