Continued from
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
(_) Light Brown
(_) Brown
(_) Black
(_) N/A
Brand of chewing tobacco you prefer:
(_)Red-Man
(_)Other (Specify________________ )
How far is your home from a paved road?
(_) 1 mile
(_) 2 miles
(_) just a whoop-and-a-holler
(_) road? |