Last name: ________________
First name: (Check appropriate box)
(_) Billy_Bob
(_) Billy_Joe
(_) Billy_Ray
(_) Billy_Sue
(_) Billy_Mae
(_) Billy_Jack
What does everyone call you?
(_) Booger
(_) Bubba
(_) Junior
(_) Sissy
(_) Other___________________
Age: ____ (if unsure, guess)
Shoe Size: ____ Left ____ Right
Occupation: (Check appropriate box)
(_) Farmer
(_) Mechanic
(_) Hair Dresser
(_) Unemployed
(_) Occupation?
Spouse's Name:_________________________
2nd Spouse's Name:______________________
3rd Spouse's Name:______________________
Lover's Name:___________________________
Relationship with spouse: (Check appropriate box)
(_) Sister
(_) Brother
(_) Aunt
(_) Uncle
(_) Cousin
(_) Mother
(_) Father
(_) Son
(_) Daughter
(_) Pet
Number of children living in household: _____
Number of children living in shed: ______
Number that are yours: ______
Father's Name: _______________________
(If not sure, leave blank)
Education: 1 2 3 4 (Circle highest grade completed)
Total number of vehicles you own: ___
Number of vehicles that still crank: ___
Number of vehicles in front yard: ___
Number of vehicles in back yard: ___
Firearms you own and where you keep them:
____ truck
____ bedroom
____ bathroom
____ kitchen
____ shed
Model and year of your pickup: ________ 196_
Do you have a gun rack?
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 in the last 5 years you've seen
Elvis:_____
Number of times you've seen Elvis in a UFO:_____
How often do you bathe:
(_) Weekly
(_) Monthly
(_) Not Applicable
(_) Bathe?
Color of eyes:
Right_____ left_____
Color of hair:
(_) None
(_) Black
(_) Red
(_) Brown
(_) White
(_) Clairol
Color of teeth:
(_) Yellow
(_) Brownish_Yellow
(_) Brown
(_) Black
(_) No teeth at all.
Brand of chewing tobacco you prefer:
(_)Red Man
How far is your home from a paved road?
(_) 1 mile
(_) 2 miles
(_) just a whoop_and_a_holler
(_) road?