APPLICATION TO LIVE IN THE SOUTH
Personal Information
Name:________________________ Nickname:___________ CB Handle:____________________ Address: ________________________ ________________________ ________________________ (RFD):_________________________________________________________ Daddy (If unknown, attach list of three suspects): 1)_____________________ 2)_____________________ 3)_____________________ Mamma:_________________________________________________________________ Neck Shade: Light Red Medium Red Dark Red Number of teeth exposed in full grin: Upper:_________ Lower:_________
Truck
Name of Pickup owned:______________ Height of truck:___________________ Truck equipped with: (Check all which apply) Gun rack 4 Wheel drive Confederate flag Toothpick holder 8-Track Load of wood Hijacker shocks Mud-grip tires Big dog Raccoon hide Dual CB antennas Mud flaps Spittoon Camper top Mag wheels Air horns Does your truck contain some part painted the official state color, Primer Red? Yes No Number of empty beer cans on floorboard of pickup:_____________________ Bumper stickers: Eat more possum Honk if you love Jesus Wave if your horny Redman Chewing Tobacco
General Information
Define the following (Must be 90% correct): Tater Muscadine Cobbler Soppin syrup Ramps Chitlins Brogans Fatback Tote Collards Redeye gravy Cracker Pinto beans Poke Sidemeat Sawmill gravy Goobers Turnip salt Grits Shit-on-shingle Favorite vocalist: Donna Fargo Conway Twitty Loretta Lynn HankWilliams Elvis Slim Whitman Tammy Wynette Porter Wagoner Johnny Cash Willie Nelson George Jones Boxcar Willie Favorite recreation: Square dancin' Possum huntin' Skinny dippin' Craw daddin' Gospel Singin' 4-Wheelin' Drankin' Bull chip throwin' Blue grass conventions Spittin' backy Creek jumpin' Other Weapons owned: Deer rifle Bird gun Varit rifle Sawed-off Shotgun Tire iron Pick handle Log chain Power (chain) saw Number of hound dogs: _______ Type: Blue tick Black &tan Beagle Favorite Emblem: John Deere CAT Budweiser McCullock chain saw PBR NAPA Coors Skoals Financial Status Number of weeks unemployed:___ Number of welfare checks received:___ Number of dependents: (Legal):_____________ (Claimed):______________ Memberships: KKK PTL Club American Legion Bass Club Moose Lodge VFW NRA Length of left leg:_______________ Length of right leg:_______________ How many cars do you have jacked up on blocks in your front yard? 1 2 3 4 5 or more Can't Count How many kitchen appliances (working or not) do you keep on your front porch? 1 2 3 4 5 or more Still can't count Will you be part of the South's Intelligentsia with a measurable I.Q.? Yes No Do you wear mostly double knit polyester pants with snags? Yes No Do you own any shoes? If so, how many?______ In what year did you last purchase shoes?_____ Are you married to any of the following? Sister Cousin Sow Do you know her name? Yes No Does your wife weigh more than your pickup? Yes No Can you sign your name and get the spelling right every time? Yes No Have you ever stayed sober for a whole weekend? Yes No Can you count: Past 10 with your shoes on? Yes No To 21 with your fly up? Yes No Do you know any words that have more than 4 letters? Yes No Medical Information: Do you or have you had at least 2 of the following: BO Crabs Head lice Bad breath Scabies Trench mouth Runny nose Tape worm Have you ever had more than one bath in a week? Yes No
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