Nickname CB Handle
Daddy (if unknown, attach list of three suspects)
Neck Shade Light Red
Medium Red Dark Red
Number of Teeth Exposed in Full Grin Upper
Make of Pickup Owned Size of Tires
Number of Empty Beer Cans on Floor of Pickup
Truck Equipped With:
Gun Rack8-TrackFuzz BusterSpittonMud
Flaps4-Wheel DriveLoad of WoodRunning
BoardsCamper TopAmerican FlagHijack ShocksCB
AntennasAir HornRustMud TiresRoll
Bumper Stickers: Wave
If You're HornyAlmost Heaven - BucksportWhere the Hell is
Orrington?Honk if You Love JesusWood Is WonderfulOlde
FartAll you Ecological Bastards can Freeze to Death in the
Dark!Dig Clams40 Isn't Old, If You're A
TreeMaine-iacRedman Chewing TobaccoI Ain't No
Flatlander!Save the Black Fly
ElvisSlim WhitmanBert & IConway
TwittyJohnny CashDick CurtisLoretta LynnWillie
NelsonWicked Good Band
Square Dancin'Drankin'Blue Grass FestivalCoon
Huntin'Drankin'Jackin'Fish'n with LIVE
Favorite Weapon: Tire
IronPick HandleLog Chain
Number of Hounds Type: Blue Tick Beagle
Black & Tan
Cap Emblem: John
NRAFish & Game ClubVFWPTL
ClubKKKDucks UnlimitedSnow Warriors
Length of Right Leg Length of Left Leg
How many cars do you have up on blocks in your front yard?
How many kitchen appliances will you keep on your front porch? (Working or
When was your last Elvis sighting?
Do you wear mostly polyester pants with snags?
Do you own any shoes (not counting boots), if so how many?
Are you married to any of the following?
Sister Cousin Cousin's Sister
Does your wife weigh more than your pickup?
Can you sign your name and spell it right every time?
Have you ever stayed sober for a whole weekend?
Can you count: Past 10 with
your shoes on? Past 21 with your
Have you EVER had more than one bath in a week? Month?
Medical Information (Do you have at least 2 of the following?):
Your Signature (one "X" will do)