APPLICATION TO LIVE IN THE SOUTH


Name:______________  Nickname:____________  CB Handle:____________ 

Address: (RFD):_________________________________________________ 

Daddy: (If unknown attach list of three suspects):_____________________ 

Mamma:_______________________________ 

Neck Shade:   []  Light Red   []  Medium Red   []  Dark Red 

Number of teeth exposed in full grin:  Upper:______  Lower:________ 

Name of Pickup Owned:______________  Height of truck:__________ 

Truck Equipped with: 
 []  Gun Rack  []  4-Wheel Drive  []  Confederate Flag  []  Toothpick Holder 
 []  8-Track   []  Load of Wood   []  Hijacker Shocks   []  Mud-grip Tires 
 []  Big Dog   []  Racoon Hide    []  Dual CB Antenna   []  Fuzz Buster 
 []  Spitoon   []  Camper Top     []  Mag Wheels        []  Air Horns  
 []  Mud Flaps 

Number of Empty Beer Cans on Floor Board of Pickup:_________ 

Bumper Stickers: 
    []  Eat More Possum   []  Peanut Butter    []  Honk if You Love Jesus 
    []  Wave if You're Horny                   []  Redman Chewing Tobacco 

Define the following (Must be 90% correct): 
 []  Grits      []  Muscadine       []  Cobbler   []  Tater 
 []  Goobers    []  Brogans         []  Fatback   []  Pig Skins 
 []  Collards   []  Redeye Gravy    []  Tote      []  Pinto Beans 
 []  Sidemeat   []  Sawmill Gravy   []  Poke      []  Turnip Salit 
 []  Chitlins   []  Soppin Syrup    []  Cracker   []  Shit-on-Shingle 
 []  Ramps 

Favorite Vocalist: 
 []  Donna Fargo   []  Conway Twitty   []  Loretta Lynn    []  Hank Williams 
 []  Elvis         []  Slim Whitman    []  Tammy Wynette   []  Porter Wagoner 
 []  Johnny Cash   []  Willie Nelson   []  George Jones    []  Box Car Willie 

Favorite Recreation: 
 []  Square Dancin'   []  Possum Huntin'      []  Skinny Dippin' 
 []  Craw Daddin'     []  Gospel Singin'      []  4-Wheelin' 
 []  Drankin'         []  Bull Chip Throwin'  []  Blue Grass Conventions 
 []  Spitten' backy   []  Other 

Weapons Owned: 
 []  Deer Rifle    []  Bird Gun      []  Varmit Rifle   []  Sawed-off Shotgun 
 []  Tire Iron     []  Pick Handle   []  Log Chain      []  Power (chain) saw 

Number of Hound Dogs:___  Type:   []  Blue Tick   []  Black & Tan   []  Beagle 

Emblem:   []  John Deere   []  CAT    []  Budweiser   []  McCullock Chain Saw 
          []  PBR          []  NAPA   []  Coors       []  Skoals 

Number of Weeks Unemployed:_____  
Number of Welfare Checks Received:_____ 

Number of Dependents (Legal):______   (Claimed):______ 

Memberships: 
 []  KKK    []  NRA   []  Moose   []  PTL Club   []  VFW   []  American Legion 
 []  Bass Club        []  United Sons/Daughters of the Confederacy 

Length of Left Leg:______  Length of Right Leg:______ 

Does your truck contain some part painted the official state color, Primer Red?______ 

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

How many kitchen appliances (working or not) will you keep on your front porch?______ 

Do you wear mostly double knit polyester pants with snags?______ 

Do you own any shoes, if so 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?______ 

Can you count:  Past 10 with your shoes on? ______ 
                To 21 with your fly up? ______ 

Medical Information: 
  Do you have at least 2 of the following:   
       []  BO       []  Crabs          []  Head Lice   []  Bad Breath 
       []  Scabies  []  Trench Mouth   []  Runny Nose 

Do you know any words that have more than 4 letters?______ 

Have you EVER had more than one bath in a week? ______