Redneck Census Guide

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 household: _____


Number of children living in 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 completed)


Do you (_) own or (_) rent your mobile home?(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 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 tooth:


(_) Yellow


(_) Brownish-Yellow


(_) Brown


(_) Black


(_) Not Applicable


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?