Redneck Census Form

The official year 2000 Redneck Census Form:

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)
Sex:____ M ____ F ____ Not sure
Shoe size:____ Left ____ Right
Occupation: (Check appropriate box)
()Farmer ()Mechanic ()Hair Dresser ()Unemployed ()Dirty Politician ()Preacher
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 the home:_____
Number of the children living in the shed:_____
Number that are yours:_____
Mother's Name:____________________ (If not sure, leave blank)
Father's Name:____________________ (If not sure, leave blank)
Education: 1 2 3 4 (Circle highest grade commpleted)
(Check appropriate box)
Total number of vehicles you own:___
Number of vehicles that still crank:___
Number of vehicles in front yard:___
Number of vehicles in the back yard:___
Number of vehicles on cement blocks:___
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?
()Yes ()No; 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
Color of eyes: Left_____ Right_____
Color of hair:
()Blond ()Black ()Red ()Brown ()White ()Clairol
Color of teeth:
()White ()Yellow ()Brownish-Yellow ()Brown ()Black ()N/A
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?