Redneck Census Form 
 
Last name: ___________________________ 
(Check appropriate box) 
First name: 
[_] Billy-Bob 
[_] Bobby-Sue 
[_] Billy-Joe 
[_] Bobby-Jo 
[_] Billy-Ray 
[_] Bobby-Ann 
[_] Billy-Sue 
[_] Bobby-Lee 
[_] Billy-Mae 
[_] Bobby-Lou 
[_] Billy-Jack 
[_] Bobby-Jean 
 
Age: ___ (if unsure, guess) 
 
Sex: m F Not sure 
 
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: ______________________ 
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 _____ 
 
Number of Firearms you own? _____ 
Where you keep them: 
[_] truck 
[_] kitchen 
[_] bedroom 
[_] bathroom 
[_] shed 
 
Model and year of your pickup: 194- 
 
Number of road kills presently in your freezer? 
[_] 3 
[_] 5 
[_] 10 or more 
 
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 you've seen Elvis _____ 
Number of times you've seen Elvis in a UFO _____ 
 
How often do you bathe: 
[_] Weekly 
[_] Monthly 
[_] Not Applicable 
 
How many teeth? _____ 
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