Application to Live in KentuckyName:__________________________ Nickname:_________________________________CB Handle Model:_____________________ Color:______________Address (RFD No.):_________________–_____________________________________Daddy (If unknown, list 3 suspects):______________________________________Mamma:_________________________Neck Shade: _____Light Red _____Medium Red _____Dark RedNumber 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____8-Track Cassettes ____Load of Wood ____Hijacker Shocks____Radar Detector ____Mag Wheels ____Dual CB Antennas____Spittoon ____Camper Top ____Air Horns____Mud Flaps ____Toothpick Holder ____Mud-Grip Tires____Raccoon Hide ____Big Dog ____Hunting RifleNumber of empty beer cans on floorboard or in bed of pickup truck:_____BUMPER STICKERS:____Eat more Possum ____My other car is a piece of shit too____Honk if you love Jesus ____If you ain’t a cowboy you aint shit____Redman Chewing Tobacco ____Wave if you’re horny____Don’t Like My Driving? Dial 1-800-Eat-Shit____If You Can Read This, Then You’s Too Smart For Kentucky____I Brake For Nuthin‘ ____National Rifle AssociationDefine the following (must be 90% correct):1. Grits 6. Sawmill Gravy 11. Cobbler 16. Tater2. Goobers 7. Turnip Salad 12. Fatback 17. Pig Skins3. Pinto Beans 8. Shit-on-a-Shingle 13. Tote 18. Okrie4. Collards 9. Redeye Gravy 14. Chickin’Fry 19. Shonuf5. Sidemeat 10. Soppin‘ Syrup 15. Poke 20. ChitlinsFavorite 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 WillieFavorite Recreation:____Square Dancin‘ ____Possum Huntin‘ ____Skinny Dippin’____Craw Daddin‘ ____Gospel Singin‘ ____4-Wheelin’____Drankin‘ ____Spittin‘ Backy ____Bill Chip Throwin’____Honky Tonkin‘ ____Noodlin‘ ____OtherName of Son(s): ____Bubba ____Jim Bob ____LeeRoy ____J.D. ____Bill Lee____Bob Lee ____DukeName of Daughter(s): ____PammySue ____Violet ____Paulette ____DaisyWeapons Owned:___Deer Rifle ___Sawed-Off Shotgun ___Varmit Rifle ___Log Cabin___Tire Iron ___Power Chain Saw ___Pick Handle ___Hick’ry SwitchNumber of Dogs:____ Type: ___Blue Tick ___Beagle ___Black & Tan ___Bird DawgCap Emblem: ___John Deer ___McCullock Chain Saws ___Budweiser ___Vo-Tech ___Skoal ___Coors ___NAPA ___Smile if You’re Not Wearing Underwear ___N.R.A. ___Redman ____KodiakNumber of Dependends: 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/Daughters of the Confederacy___John Birch SocietyLength of Right leg:________ Length of Left leg:__________Number of Testicles Shot off in ‚Nam____ Number of Testicles Left____Does your truck contain some part painted the offical state color ofPrimer Red? ___Yes ___NoHow 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 ____SowDo 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?_________________ To 21 with your fly up?_____________________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 ___Crabs ___Head Lice ___Rabies___Trench Mouth ___Runny Nose ___Bad Breath ___ChafingIF YOUR APPLICATION IS TURNED DOWN BY THE STATE OF KENTUCKY, YOU MAY BEELIGIBLE IN THE STATES OF TEXAS, OKLAHOMA, OR ARKANSAS. THEIR STANDARDS ARESLIGHTLY LOWER, HOWEVER, YOU WOULD STILL BE ABLE TO VISIT KENTUCKY.
