The 2000 Federal Census for Red-necks

Last name:___________________
First name:(Check appropriate box)
(_)Billy-Bob
(_)Billy-Joe
(_)Billy-Ray
(_)Billy-Sue
(_)Billy-Jack
(_)Billy-Mae

What does everyone call you?
(_)Booger
(_)Bubba
(_)Junior
(_)Sissy
(_)Other__________

Age:____(if unsure, guess)
Sex:____M____F____Not sure
Shoe size:____Left_____Right
Occupation:(Check appropriate box)
(_)Farmer
(_)Mechanic
(_)Hair Dresser
(_)Unemployed
(_)Dirty Politician
(_)Preacher

Spouse's Name:____________________ 2nd Spouse's Name:_________________
3rd Spouse's Name:_________________ Lover's Name:______________________
Relationship to spouse: (Check appropriate box)
(_)Sister
(_)Brother
(_)Aunt
(_)Cousin
(_)Mother
(_)Father
(_)Son
(_)Daughter
(_)Pet

Number of children living in household:_____ Number of children living
in
>>
shed:_____
Number that are yours:_____ Mother's name:_________________(If not sure,
leave blank)
Father's name:_________________(If not sure, leave blank)
Education: 1 2 3 4 (Circle highest grade completed)
Do you (_)own or (_) rent your mobile home? (Check appropriate box)
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:____
Firearms you own and where you keep them:
____truck
____bedroom
____bathroom
____kitchen
____shed

Model and year of your pickup: 196_
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

Number of times you've seen a UFO:____
Number of times in the last 5 years you've seen Elvis:____
Number of times you've seen Elvis in a UFO:____

How often do you bathe:
(_)Weekly
(_)Monthly
(_)Not applicable

Color of eyes:
Left____Right____

Color of hair:
(_)Blond
(_)Black
(_)Red
(_)Brown
(_)White
(_)Clairol

Color of teeth:
(_)Yellow
(_)Brownish-yellow
(_)Brown
(_)Black
(_)N/A

Brand of chewing tobacco you prefer:
(_)Red-Man

How far is your home from a paved road?
(_)1 mile
(_)2 miles
(_)just a whoop-and-a-holler
(_)road?