Jeszcze drobna ankietka na koniec, agencja rolna usa chce się dowiedzieć kilku faktów o yankees <imgs src="../../buziaki/7.gif" align=middle>
Plez compleet this paper, best ya can.
Last name: ______________________________
First name:
[_] Billy-Bob [_] Bobby-Sue
[_] Billy-Joe [_] Bobby-Jo
[_] Billy-Ray [_] Bobby-Ann
[_] Billy-Sue [_] Bobby-Lee
[_] Billy-Mae [_] Bobby-Ellen
[_] Billy-Jack [_] Bobby-Beth
[_] Badd-Teddy Bob
Age: ____ (if unsure, guess)
Sex: [_]M [_]F [_]None
Shoe Size: ____ Left ____ Right
Occupation:
[_] Farmer [_] Mechanic
[_] Hair Dresser [_] Waitress
[_] Un-employed [_] Dirty Politician
Spouse's Name: ______________________________
2nd Spouse's Name: __________________________
3rd Spouse's Name: __________________________
Lover's Name: _______________________________
2nd Lover's Name: ___________________________
Relationship with spouse:
[_] Sister [_] Aunt
[_] Brother [_] Uncle
[_] Mother [_] Son
[_] Father [_] Daughter
[_] Cousin [_] Pet
Number of children living in household: ___
Number of children living in shed: ___
Number of children that are yours: ___
Mother's Name: _______________________
(Relation__________)
Father's Name: _______________________
(Relation__________)
Education: 1 2 3 4 (Circle highest grade completed)
If you obtained a higher education what was your major?
[_] 5th grade [_] 6th grade
Do you [_] own or [_] rent your mobile home?
Vehicles you own and where you keep them:
___ Total number of vehicles you own
___ Number of vehicles that still crank
___ Number of vehicles in front yard
___ Number of vehicles in back yard
___ Number of vehicles on cement blocks
Age you started drivin ______
If over 10, are you are still slow lerrnin? [_] Yes [_] No
Firearms you own and where you keep them:
____ truck ____ kitchen
____ bedroom ____ bathroom/outhouse
____ shed ____ pawnshop
Model and year of your pickup: _____________ 194_
Do you have a gun rack?
[_] Yes [_] No If no, please explain:
Newspapers/magazines you subscribe to:
[_] The National Enquirer [_] The Globe
[_] TV Guide [_] Soap Opera Digest
[_] Rifle and Shotgun [_] Bassmasters
___ Number of times you've seen a UFO
___ Number of times you've seen Elvis
___ Number of times you've seen Elvis in a UFO
___ Do you hunt Bear? If so, please do not explain
How often do you bathe:
[_] Weekly
[_] Monthly
[_] Not Applicable
How many teeth in YOUR mouth? ___
Color of teeth:
[_] Yellow [_] Brownish-Yellow
[_] Brown [_] Black [_] N/A
Brand of chewing tobacco you prefer:
[_] Red-Man [_] Skoal
How far is your home from a paved road?
[_] 1 mile
[_] 2 miles
[_] don't know
Distance between mobile home and Bubba's House of Beer ?
How many times has you received a DWI this year?____
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