First name: ...................
Last name (if known): .......................
Address (where you live):
Mother's name (list also relation, i.e., sister): ..................
Birthdate (yours): ....................
Father's name (if known, if not, list two possible choices): ..............
Color of neck: Light Red( ) Medium Red( ) Dark Red( ) No Neck( )
Year of pickup truck: ............
Do you have the following in your truck:
Fuzzy Dice( ) Gun Rack( ) Coon Tail( )
Filled ash tray( ) Used Condoms( )
Dead Road Kill( ) Dog of Unknown Breed( )
Have you ever been to a large city? (Like Little Rock) Yes( ) No( )
How far can you throw cow pies? ..........
Do you eat cow pies? Yes( ) No( )
Wife's name: .................. Is she: Cousin( ) Neighbor( ) Sister( ) Mother( ) Neighbor's dog( ) Right hand( )
Does your wife weigh: Less than 200 Pounds( ) Less than 300 Pounds( ) Less than a 747( ) More than a 747( )
Do you know what a 747 is? Yes( ) No( )
How much smarter than you is your wife: 50 IQ Points( ) 75 IQ Points( ) 100 IQ Points( ) She Won't Tell Me( )
Does your wife wear: A Dress( ) Pants( ) Hot Pants( ) Your Pants( ) Them Lawyer Clothes( ) Nothing( ) Nothing but an Arkansas U Hog Head Hat( )
Color of wife's hair: Blonde( ) Red( ) Brown( ) Black( ) Bald( )
Did you understand the previous questions: Yes( ) No( ) What does "previous" mean?( ) Huh?( ) All of the Above( )
Have you ever had (check all that apply): Herpes( ) Jock Rot( ) The Drip( ) Roids( ) Zits( ) Smelly Feet( ) Toe Jam( ) Bad Breath( ) Tit Munge( ) Ear Wax( ) Long Nasal Hairs( ) Brown Nose( )
Have you ever:
Castrated a Pig( ) Been Castrated by a Pig( )
Danced to Achey Breaky Heart( ) Had an Achey Breaky Heart( )
Been Mistaken for Elvis( ) Had Fantasies about Toto( )
Had Fantasies about Dorothy and Toto( )
Had Fantasies about Gilligan( )
Had Fantasies about Gilligan and the Skipper Too( )
Inhaled( )
Where was your last Elvis sighting? ................ On what date? ...........
Can you count past five: Yes( ) No( ) Past ten: Yes( ) No( )
Explain in ten words or less why on Earth you want to be Governor of Arkansas:
Signature (or 'X' if you can't write) ................................