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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 ( ) SHIT HAPPENS ( ) REDMAN CHEWING TOBACCO ( ) WOOD IS WONDERFUL ( ) SAVE THE BLACK FLY ( ) DON'T LIKE MY DRIVING? CALL 1-800-EAT-SHIT ( ) ALL YOU ECOLOGICAL BASTARDS CAN FREEZE IN THE DARK Define the following (must be 90% correct): 1. Grits 2. Goobers 3. Pinto Beans 4. Collards 5. Sidemeat 6. Sawmill Gravy 7. Turnip Salad 8. Shit-on-a-Shingle 9. Redeye Gravy 10. Soppin' Syrup 11. Cobbler 12. Fatback 13. Tote 14. Chickin' Fry 15. Poke 16. Tater 17. Pig Skins 18. Okrie 19. Shonuf 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 Do you own any shoes? ____Yes ____No If yes, how many?__________ What year did you last purchase shoes?_________________ 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: ____________

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