The Loony Bin
(
loonies@bloodaxe.demon.co.uk
)
Mon, 21 Oct 1996 01:47:23 +0100
Hiya All... Another application form... Wishes & Dreams... - ANDREA xx *************<andrea@bloodaxe.demon.co.uk>************* *****<ajc6@ukc.ac.uk>*****<bloodaxe@geocities.com>***** *** *** *** THE LOONY BIN *** *** loonies@bloodaxe.demon.co.uk *** *** Archive: http://eleceng.ukc.ac.uk/~pjw/loonies/ *** *** *** *******************Internet Goddess******************** **********************ANDROMEDA************************ ------- Forwarded foolishness follows ------- ALABAMA STATE 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 (_)Asbestos Worker (_)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_ Newspapers/magazines you subscribe to: (_)The National Enquirer (_)The Globe (_)TV Guide (_)Soap Opera Digest ___ 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 Organizations that you belong to: (Check all that are applicable) (_) NRA (_) PTL (_) 700 Club (_) KKK (_) NHRA Number of tractor pulls you've been to this month : (_) <5 (_) 5-10 (_) 11-15 (_) Can't count Beverage of choice: (_) Night Train (_) Blind Dog Bourbon (_) Cousin Cletus' Moonshine (Non-Commercial) (_) Gasoline Number of Skoal Belt Buckles You Own:____ Brand of Jeans you prefer: (_) Wranglers Do you play the banjo? (_) Yes