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 Rack 8-Track Fuzz Buster Spitton Mud Flaps 4-Wheel Drive Load of Wood Running Boards Camper Top American Flag Hijack Shocks CB Antennas Air Horn Rust Mud Tires Roll Bar
Bumper Stickers: Wave If You're Horny Almost Heaven - Bucksport Where the Hell is Orrington? Honk if You Love Jesus Wood Is Wonderful Olde Fart All you Ecological Bastards can Freeze to Death in the Dark! Dig Clams 40 Isn't Old, If You're A Tree Maine-iac Redman Chewing Tobacco I Ain't No Flatlander! Save the Black Fly
Favorite Beverage: Genessee Moosehead Nastygansett Labatt Bangor Tap Water Molson Budweiser
Favorite Vocalist: Elvis Slim Whitman Bert & I Conway Twitty Johnny Cash Dick Curtis Loretta Lynn Willie Nelson Wicked Good Band
Favorite Recreation Square Dancin' Drankin' Blue Grass Festival Coon Huntin' Drankin' Jackin' Fish'n with LIVE BAIT Drankin' Get'n Drunk
Favorite Weapon: Tire Iron Pick Handle Log Chain
Number of Hounds Type: Blue Tick Beagle Black & Tan
Cap Emblem: John Deere Sugarloaf Stihl Ski-Doo Foggy Mt. Skoal CAT Budweiser
Memberships: NRA Fish & Game Club VFW PTL Club KKK Ducks Unlimited Snow 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. Scabies Tattoos Crabs Yellow Teeth Cross-Eyed Head Lice Green Teeth Stutter Bad Breath Runny Nose Fleas
Your Signature (one "X" will do)