Nickname CB Handle
Address (RFD)
Daddy (if unknown, attach list of three suspects)
Mamma
Neck Shade Light Red Medium Red Dark Red
Number of Teeth Exposed in Full Grin Upper Lower
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 Bar
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
Favorite Beverage: GenesseeMooseheadNastygansettLabattBangor Tap WaterMolsonBudweiser
Favorite Vocalist: ElvisSlim WhitmanBert & IConway TwittyJohnny CashDick CurtisLoretta LynnWillie NelsonWicked Good Band
Favorite Recreation Square Dancin'Drankin'Blue Grass FestivalCoon Huntin'Drankin'Jackin'Fish'n with LIVE BAITDrankin'Get'n Drunk
Favorite Weapon: Tire IronPick HandleLog Chain
Number of Hounds Type: Blue Tick Beagle Black & Tan
Cap Emblem: John DeereSugarloafStihlSki-DooFoggy Mt.SkoalCATBudweiser
Memberships: 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 Not)
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 Sow
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 fly up?
Have you EVER had more than one bath in a week? Month?
Medical Information (Do you have at least 2 of the following?):
B.O.ScabiesTattoosCrabsYellow TeethCross-EyedHead LiceGreen TeethStutterBad BreathRunny NoseFleas
Your Signature (one "X" will do)