Name:__________________________________
NickName:______________________________
CB Handle______________________________
Address:(if any)__________________________
Daddy:(if
unknown, attach list of 3 suspects)
______________________________
______________________________
______________________________
Neck: LightRed_____MediumRed___ DarkRed ______
Number
of teeth exposed in full grin:
Upper____ Lower____
Length of: Right Leg______ Left Leg________
Pick Up Truck: Type_____________
Size of Tires_______
Hounds/type: BlueTick____ Beagle_____ Walker_____
Trigg _______ Other_________
How Many Cars?: FrontYard________BackYard_________
On Blocks________
How Many Kitchen Appliances?
FrontPorch______ BackPorch_______
When was your last Elvis Sighting?
Date__________ Time__________
Do you wear mostly Polyester Pants?
Yes___ No___
Do you own a pair of shoes? (Not Boots)
Yes__ No __
Does your wife weigh more than your pickup?
Yes___ No ___
Can you spell your name and always spell it right?
Yes___ No ___
Have you ever had more than one bath in a week?
Yes_____ No_____
Are you married to any of the following?:
Sister___Cousin____Cousins___
Sister___Aunt______Other___
(please explain):
_____________________________
How many Children do you have?____
Number of children you had before your 19th
birthday?_____
Number of possible fathers?____
Medical Information (circle your answers)
Do you have any of the following?
BO Crabs BadTeeth Lice Tattoo's
Scabies Fleas Crossed Eyes Runny Nose
Green Teeth Brown Teeth Yellow Teeth
False Teeth
Number of Missing Teeth?_____
General Information
Can you Count higher than 10? (shoes on)
Yes____ No___
Can you Count higher than 21? (fly up)
Yes___No ____
Favourite Weapon:
TireIron:___ ChainSaw:___ PickHandle:_____
Shotgun:___ Broom:____ Paintball-gun___
Other:_________________
Your Favourite Past Time:
Drinking_____ CoonHunting______
Fishing_______Other_____________
Truck Equipped with:
GunRack_____FuzzBuster______ CB______
RollBar______Other____________________
Favourite Singer:
Elvis_____ Willie Nelson_____
Johnny Cash______Conway-Twitty______
Other___________
Bumper Stickers:
Honk-if-You-Love-Jesus__Honk-if-your-Horny__
Dial-1-800-EAT-SHIT__Old-Fart_______
I dig-Clams_______Other_____________
Emblems:
JohnDeere______CC_____Labatts50_____
JackDaniels_____Southern-Comfort_____
Other _____________________
Memberships:
IRA_____ AA______Legion________
CAA________Other________________
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