Application to be a redneck

Name:__________________________ Nickname:_________________________________

CB Handle:_____________________

Address (RFD No.):_________________--_____________________________________

Daddy (If unknown, list 3 suspects):______________________________________

Mamma:_________________________

Neck Shade: _____Light Red _____Medium Red _____Dark Red

Number of teeth exposed in full grin: Upper_____ Lower_____

Type of Pickup owned:_______________ Height of Truck__________

Truck equipped with:
Yes ----------------------------No
__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 ___
__ "BOCEPHUS" bumper sticker ___
__ Red Man chewing tobacco bumper sticker ___
__ I love grits bumper sticker ___
__ "AMERICA, LOVE IT OR LEAVE IT" bumper sticker ___
__ Desert Storm bumper sticker ___
__ 12 foot CB antenna ___
__ Illegaly altered 1 gigawatt CB transmitter ___
__ Spitoon ___
__ Mud Flaps ___
__ Curb Feelers ___ ___
__ Shot Guns in back window ___

Number of empty beer cans on floorboard or in bed of pickup truck:_____

BUMPER STICKERS:
( ) HONK IF YOU'RE HORNY ( ) HONK IF YOU LOVE JESUS
( ) ALMOST HEAVEN, BUCKSPORT ( ) SNATCH KISSES AND VICE VERSA
( ) OLD FART ( ) I LOVE HINEY WINE
( ) STUFF HAPPENS ( ) REDMAN CHEWING TOBACCO
( ) WOOD IS WONDERFUL ( ) SAVE THE BLACK FLY
( ) DON'T LIKE MY DRIVING? CALL 1-800-EAT-S---
( ) ALL YOU ECOLOGICAL SCUMBAGS CAN FREEZE IN THE DARK

Define the following (must be 90% correct):

1. Grits 6. Sawmill Gravy 11. Cobbler 16. Tater
2. Goobers 7. Turnip Salad 12. Fatback 17. Pig Skins
3. Pinto Beans 8. Shit-on-a-Shingle 13. Tote 18. Okrie
4. Collards 9. Redeye Gravy 14. Chickin' Fry19. Shonuf
5. Sidemeat 10. Soppin' Syrup 15. Poke 20. Chitlins

Favorite Vocalist:

____Reba McEntire ____Conway Twitty ____Loretta Lynn
____Hank Williams Jr. ____Randy Travis ____Ray Wylie Hubbard
____Tammy Wynette ____Slim Whitman ____Porter Wagoner
____Willie Nelson ____George Jones ____Box Car Willie

Favorite Recreation:

____Square Dancin' ____Possum Huntin' ____Skinny Dippin'
____Craw Daddin' ____Gospel Singin' ____4-Wheelin'
____Drankin' ____Spittin' Backy ____Bill Chip Throwin'
____Honky Tonkin' ____Noodlin' ____Other

Name of Son(s): ____Bubba ____Jim Bob ____LeeRoy ____J.D.

Name of Daughter(s): ____PammySue ____Violet ____Paulette ____Daisy

Weapons Owned:

___Deer Rifle ___Sawed-Off Shotgun ___Varmit Rifle ___Log Cabin
___Tire Iron ___Power Chain Saw ___Pick Handle ___Hick'ry Switch

Number of Dogs:____ Type: ___Blue Tick ___Beagle
___Black & Tan ___Bird Dawg

Cap Emblem: ___John Deer ___McCullock Chain Saws ___Budweiser
___Vo-Tech ___Skoal ___Coors
___NAPA ___Smile if You're Not Wearing Underwear

Number of Dependents: Legal:________ Claimed:_________

Number of Weeks Unemployed:__________

Number of Welfare Checks Received:____________

Memberships:

___KKK ___NRA ___Moose ___PTL Club ___AA
___Bass Club ___VFW ___Quiltin' Bee ___American Legion
___United Sons n' Daughters of the Confederacy
___John Birch Society

Length of Right leg:________ Length of Left leg:__________

Does your truck contain some part painted the offical state color of
Primer Red? ___Yes ___No

How many cars do you have jacked up on blocks in your front yard?_______

How many kitchen appliances will you keep on your front porch?__________

Will you wear mostly double-knit polyester pants with snags?____________

Do you own any shoes? ____Yes ____No If yes, how many?__________

What year did you last purchase shoes?_________________

Are you married to any of the following:

____Sister ____Cousin ____Sow

Do you know her name?________________

Does your wife weigh more than your pickup?____________

Can you sign your name and get the spelling right every time?____________

Have you ever stayed sober for a whole weekend?________________

If so, why?______________________________________________________________

Can you count: Past 10 with your shoes on?_________________

Do you know any words that have more than four letters?__________________

Have you ever had more than one bath in a week?__________________________

Medical Information:

Do you have at least two of the following:

___BO ___Head Lice ___Rabies
___Trench Mouth ___Runny Nose ___Bad Breath

FAVORITE BEVERAGE:

( ) BUSCH ( ) STAG ( ) OLD STYLE ( ) FALSTAFF
( ) BUCKHORN ( ) RED WHITE & BLUE ( ) BUDWEISER ( ) OLD MILWAUKEE

ARE YOU A REGISTERED VOTER? ________ DO YOU KNOW WHERE TO DO IT? ________

DO YOU WONDER IF YOU NEED TO FILE A TAX RETURN? ( ) YES ( ) NO

DO YOU WORRY THAT YOUR HOUSE COULD BLOW AWAY IN HIGH WINDS? ( ) YES ( ) NO

WHEN WAS YOUR LAST UFO SIGHTING? ___________ ELVIS SIGHTING? ___________

Approximate size and weight of beer belly:______ Brand of beer:_____

Brand of chewing tobacco:______ Brand of snuff:______

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

Yes No
-- Gardens made of old tires ___ ___
-- Trucks or cars ___ ___
-- Chickens or goats ___ ___
-- Household appliances ___ ___
-- Old trailers ___ ___
-- Bath tubs ___ ___
-- TV sets ___ ___

Describe your last Elvis sighting: ______________________________________

Did you think the movie "Deliverance" was a comedy? ___________

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___ Job interviews ___

Fancy restaurants like Denny's____

Do you bathe with: Soap___ Relatives___ Small animals___

How often: Weekly___ Monthly___ Twice a year___ Once 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 or less than: Your guitar___ Your truck___

Have you seen her in the past: Two weeks___ Two months___ Two years

Have you ever seen her when she wasn't: Pregnant___ Barefoot___ Mad___

SIGNATURE (ONE `X' WILL DO) ___________________________ DATED: ____________

IF YOUR APPLICATION IS TURNED DOWN BY THE STATE OF WEST VIRGINIA, YOU MAY
BE ELIGIBLE IN THE STATE OF ARKANSAS -- THEIR STANDARDS ARE SLIGHTLY
LOWER. HOWEVER, YOU WOULD STILL BE ABLE TO VISIT WEST VIRGINIA.