Name:________ Nickname: Bubba_______ Skeeter_______ Other____

Can you spell your name correctly?
Sometimes______ Never_____ With Help_____

Current Addess:_________________________________

Number of Months Behind on Rent:_______

Neck Shade: Light Red_____ Medium Red_____ Dark Red_____ Peeling_____

Number of Teeth in full grin: 1___ 2___ 3___ More?_______

Approximate size and weight of beer belly:___________

Brand of Beer____

Brand of Chewing Tobacco:_________

Brand of Snuff:______________

Make of Pick-up truck:________ Size of Tires:________ 4 Wheel Drive?_____

Does it have doors?_____

Number of Months Behind on Payments:__________

Altitude of Running Boards: 3'______ 6'______ 12'______ 16'______

Number of Empty Beer Cans Under the Seat:________ Broken Windows?_______

Is Your Truck Appropriately Equipped with the following?

-- 8 track Hank Williams tapes: __________
-- Pit bull: __________
-- Air Horns: __________
-- Roll Bar: __________
-- Steer Horns on hood: __________
-- Musical horn that plays "Dixie" __________
-- "David Duke For President" bumber sticker __________
-- "BOCEHPUS" bumper sticker __________
-- Red Man chewing tobacco bumper sticker __________
-- I love grits bumper sticker __________
-- "America, Love it or Leave it" bumper sticker __________
-- 12 foot CB antenna __________
-- Illegaly altered 1 gigawatt CB transmitter __________
-- Spitoon __________
-- Mudflaps __________
-- Curb Feelers __________
-- Shot Guns in back window __________

How many of the following items are in your front yard: (working or not)

-- Gardens made of old tires (tractor or truck) __________
-- Trucks or cars __________
-- Chickens or goats __________
-- Household appliances __________
-- Old Trailers __________
-- Bath Tubs __________
-- TV sets __________

Describe your last Elvis sighting:________________________________

Have you ever taken a date to a tractor pull?___ Hog calling contest?___

Do you own any of the following? Fertilizer hat?____ Feed hat?_______

Shoes?______ Belt buckles that weigh more than three pounds?_____________

If so: Have you worn them to Funerals_____ Weddings______ Church_______

Do you bathe with: Soap_______ Relatives________ Small animals_______

How often? Weekly______ Monthly______ Once a year_____ Twice a year____

Have you ever been shot at by: Ay-rabs___ Gooks___ Angry Husbands______

Wives_____ Fathers-in-law______ Mothers-in-law________ The Law_______

Does your wife weigh more than or less than: Your guitar___ Your truck__

Have you seen her in the past: Two weeks____ Two months____ Two years__

Have you seen her when she wasn't: Pregnant____ Barefoot____ Mad______

Have you ever stayed sober for a whole weekend:_____________

If you have had someone read all the above questions to you and you have completely understood them then place an "X" on the line below.


Witness Signature________________________________



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Idiots in the Room

"If there are any idiots in the room, will they please stand up?" said the sarcastic teacher. After a long silence, one freshman rose to his feet. "Now then mister, why do you consider yourself an idiot?" enquired the teacher with a sneer. "Well, actually I don't," said the student, "but I hate to see you standing up there all by yourself."
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