Application To Live In Kentucky

Name__________________________Nickname__________________________
Hollow or Creek______________________Road_______________________
Daddy(If unknown, attach list of suspects)______________________
Mamma___________________Neckshade ( )Lt.Red ( )Med.Red ( )Dk.Red
Number of teeth shown in full grin: Upper________Lower__________
Name of pickup truck____________________________________________
Truck equipped with:
  ( )Gun Rack        ( )4-Wheel Drive        ( )Conferate Flag
  ( )Load of Wood    ( )HiJacker Shocks      ( )Fuzz Buster
  ( )Mudgrip Tires   ( )Spitoon or Pop Bottle( )Mag Wheels
  ( )Coon Tail       ( )Camper Top           ( )Dog with Ticks
  ( )Eight Track     ( )Tooth Picks          ( )Dual CB Ant.
  ( )Air Horns
Number of empty beer cans on floorboard of pickup_______________
Are at least some of the parts of this truck painted the official
state color of primer?  Yes_________________ No_________________
Define the following. (You must get at least 9 our of 10!!!!!!!!)
   1. Opposite Sex    2. Red Eye Gravy       3. Poke
   4. Soup Beans      5. Cracklins           6. Sawmill Gravy
   7. Taters          8. Cord                9. Lasses
  10. Maters
Vocalists whose eight tracks you have bought or stolen:
   ( )Donna Fargo    ( )Conway Twitty        ( )Hank Williams
   ( )Porter Waggoner( )Loretta Lynn         ( )Johnny Cash
   ( )Tammy Wynette  ( )Slim Whitman         ( )George Jones
   ( )Willie Nelson  ( )Box Car Willie
Favorite recreation:
   ( )Square Dancin  ( )Possum Huntin        ( )Rooster Fights
   ( )Drankin        ( )Spittin Backer       ( )Cat Fishin
   ( )Skinny Dippin  ( )Wrestlin
Weapons owned:
   ( )Deer Rifle     ( )Bird Gun             ( )Chain Saw
   ( )Tire Tool      ( )Choppin Ax           ( )Double Barrel
   ( )Skinnin Knife  ( )Varmit Rifle
Number of hound dogs:________
   ( )Blue Tick  ( )Red Bone  ( )Black & Tan  ( )Beagle
Number of dogs named:
   Ol Red___ Ol Blue___ Dog___ Mutt___ Sooner___
Cap emblem:
   ( )John Deere     ( )Pabst Blue Ribbon    ( )BF
   ( )NAPA           ( )Jack Danials         ( )CAT
   ( )Skoal          ( )Rooster Run
Number of days last welfare check lasted:_____
How many cars/trucks do you have on blocks in your front yard (jacked-up)? ________
How many kitchen appliances (working or not) do you have on your front porch? ________
Do you own shoes: Yes_____ No_____ What year did you buy your last pair?_____
Are you married to any of the following:
   ( )Your sister    ( )Your cousin          ( )Farm animal
Can you sign your name and get it right every time? Yes___ No___
Have you ever stayed sober for an entire weekend? Yes___ No___
Can you count past 10 with your shoes on? Yes___ No___
Do you have at least two of the following medical conditions?
   1. Body odor            2. Crabs (Flidder critters)
   3. Head lice            4. Compulsive Nose Picking
   5. Scabies              6. Smoker's cough
   7. Runny nose           8. Trench mouth
   9. Gas
Do you know any words with more than 4 letters? Yes___ No___
Can you spell them? Yes___ No___
Have you ever taken more than one bath in a single week? 
Yes___ No___

Sign your name here or make your mark: _________________________
Witness of mark sign here: _____________________________________