Kentucky

STATE OF KENTUCKY RESIDENCY APPLICATION FORM


Name: ______________ (last)


First:(Please tick appropriate box)


Billy-Bob [ ]
Billy-Joe [ ]
Billy-Ray [ ]
Billy-Sue [ ]
Billy-Mae [ ]
Billy-Jack [ ]


Shoe size: ______ (left) ________ (right)


Occupation:


Farmer [ ]
Mechanic [ ]
Hair Dresser [ ]
Unemployed [ ]


Relationship with spouse:


sister [ ]
brother [ ]
aunt [ ]
uncle [ ]
cousin [ ]
mother [ ]
father [ ]
son [ ]
daughter [ ]
pet [ ]


Education: 1 2 3 4 (tick highest grade completed)


Do you own [ ] or rent [ ] your mobile home?


___ total number of vehicles you own
___ number of vehicles that still crank
___ number of vehicles in front yard
___ number of vehicles in 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 pick-up: __________194__


Do you have a gun rack? [ ]yes [ ]no. (If no, please explain)


___ number of times you've seen Elvis
___ number of times you've seen a UFO
___ number of times you've seen Elvis in a UFO


How often do you bathe:


weekly [ ]
monthly [ ]
N/A [ ]


Colour of teeth:


yellow [ ]
brownish-yellow [ ]
brown [ ]
black [ ]
N/A [ ]


How far is your home from a paved road:


1-5 miles [ ]
5-10 miles [ ]
don't know [ ]