Application to live in
My Home Town






        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________________

 Main Page ~Back to the beginning
 Splitaparts ~For my philosophy on love
 Friends ~Some of the great people I have met online
 The Invitation ~Great words of wisdom
 What I Have Learned ~Wise words from a friend
 Strange & Unusual ~Strange news or unusual sites
 How To Speak Canadian
 Links ~Some of my favourite links

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