STATE OF KENTUCKY RESIDENCY APPLICATION

 Name: ________________  (_) Billy-Bob

           (last)        (_) Billy-Joe

                         (_) Billy-Ray

                         (_) Billy-Sue

                         (_) Billy-Mae

                         (_) Billy-Jack

                         (Check appropriate box)



  Age: ____

  Sex: ____ M _____ F _____ N/A

  Shoe Size ____ Left ____ Right



  Occupation:

  (_) Farmer

  (_) Mechanic

  (_) Hair Dresser

  (_) Un-employed



  Spouse's Name: __________________________



  Relationship with spouse:

  (_) Sister

  (_) Brother

  (_) Aunt

  (_) Uncle

  (_) Cousin

  (_) Mother

  (_) Father

  (_) Son

  (_) Daughter

  (_) Pet



  Number of children living in household: ___



  Number that are yours: ___



  Mother's Name: _______________________



  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: _____________ 194_



  Do you have a gun rack?

  (_) Yes (_) 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 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 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

  (_)don't know

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