STATE of PUNJAB

          DRIVING LISENCE APPLIKASON PHOROM
  NOTE : If you dont know the answers, please copy  from another applikason phorom and submit. For further  instructions, see bottom applikason. Please do not shoot the person at the  applikason kounter. He will give you the lisence immediately.

Last name:  (Kaur/Singh/do not know)
First name: (_) Balwinder
                  (_) Jaswinder
                  (_) Surinder
                  (_) Joginder
                  (_) Maninder
                  (_) Dont know
(Check appropriate box)
Age:       (_) Less than zero
              (_) Zero
              (_) Greater than zero
              (_) Don't know

Sex:  ____ M _____ F _____ not sure _____ not  applicable

Chappal Size:  ____ Left ____ Right

Occupation: (_) Farmer
                   (_) Mechanic
                   (_) Pehelwaan
                   (_) House wife
                   (_) Un-employed

Spouse's Name: 1.__________________________
                         2.__________________________

Relationship with spouse : (_) Sister
                                        (_)Brother
                                        (_) Aunt
                                        (_) Uncle
                                        (_) Cousin
                                        (_) Mother
                                        (_) Father
                                        (_) Son
                                        (_) Daughter
                                        (_) Pet

Number of children living in household: ._____

Number that are yours: ___
Mother's Name: _______________________
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: _____________ 194_

Do you have a gun rack? (_)Yes (_) No; If no, please explain:

Newspapers/magazines you subscribe to:
 Champak                                                    (_)
 Indrajal                                                       (_)
 Star and style                                              (_)
The great Punjab Dairy                                 (_)
 Blank sheets                                                                    (_)
 

___ Number of times you've SHOT a UFO
___ Number of times you've SHOT another person exactly like you
___ Number of times you've SHOT yourself.(SHOOTING  YOURSELF IN MIRROR
IS POOR SHOOTING)

Do you bathe? (_) Yes
               (_) No
               (_) Not applicable

If yes, how often do you bathe?
  (_) Weekly
  (_) Monthly
  (_) Not Applicable

 Color of teeth: (_) Yellow
                  (_) Brownish-Yellow
                  (_) Brown
                  (_) Black
                  (_) Others - Give exact color (call nearest Asian
Paints dealer if U dont know the color of your teeth) :______________
                  (_) Not applicable

  How far is your home from a paved road?
                               (_)1 mile
                               (_)2 miles
                               (_)don't know

NOTE : IF YOU DONT HAVE BOTH HANDS, YOU CANNOT  DRIVE.

For instructions to fill this applikason pharom, see  beginning of applikason phorom.