APPLICATION TO LIVE IN MAINE
                         (FLATLANDERS NEED NOT APPLY)
 
Name:
Nickname:                                C.B. Handle:
 
Daddy (if unknown, attach list of three suspects):
Mama
 
Neck Shade:      ()Light Red   ()Medium Red  ()Dark Red
 
Number of Teeth Exposed in:   Full Grin      Upper      Lower
 
Make of Pickup Owned:                        Size of Tires:
Number of Empty Beer Cans on Floor of Pickup:
 
Truck Equipped With (check all that apply):
()Gun Rack      ()Mud Flaps        ()Camper Top      ()Air Horn
()8-Track       ()4-Wheel Drive    ()American Flag   ()Rust
()Fuzz Buster   ()Load of Wood     ()Hijack Shocks   ()Mud Tires
()Spittoon      ()Running Boards   ()C.B. Antennas   ()Roll Bar
 
Bumper Stickers (check all that apply):
()Honk If You're Horny             ()I Dig Clams
()Almost Heaven, Bucksport         ()I Snatch Kisses and Vice a Versa
()Where the Hell is Orrington      ()Maine-iac
()Honk if You Love Jesus           ()Redman Chewing Tobacco
()Wood is Wonderful                ()I Ain't No Flatlander
()Olde Fart                        ()Save the Black Fly
()All You Ecological Bastards can Freeze to Death in the Dark!
 
Favorite Beverage:
()Genessee     ()Nastygansett       ()Labatts     ()Molson
()Moosehead   ()Bangor Tap Water   ()Budweiser
 
Favorite Vocalist:
()Elvis          ()Conway Twitty   ()Loretta Lynn
()Slim Whitman   ()Johnny Cash     ()Willie Nelson
()Dick Curless   ()George Jones    ()Bert & I
 
Favorite Recreation:
()Square Dancin'    ()Coon Huntin'   ()Fishin' with Live Bait
()Drinkin'          ()Drinkin'       ()Drinkin'
()Bluegrass Fest.   ()Jackin'        ()Get'n Drunk
 
Favorite Weapon:
()Tire Iron   ()Pick Handle   ()Log Chain
 
Number of Hounds:            Type:   ()Blue Tick       ()Beagle
                                     ()Black and Tan
 
Cap Emblem:
()John Deere   ()Stihl    ()Foggy Mt.   ()CAT
()Sugar Loaf   ()Eat Me   ()Skoal       ()Budweiser
 
Memberships (check all that apply):
()NRA               ()VFW           ()PTL Club        ()KKK
()Ducks Unlimited   ()Fish & Game   ()Snow Warriors
 
Length of Right Leg:            Length of Left Leg:
 
How many cars do you have on blocks in your front yard?
How many kitchen appliances do you keep on your front porch?
When was your last Elvis sighting?
Do you wear mostly polyester pants with snags?
Do you own any shoes (not counting BOOTS)?        If yes, how many:
 
Are you married to any of the following (check all that apply):
()Sister   ()Cousin   ()Cousin's Sister   ()Sow
 
Does your wife weigh more than your pickup?
Can you sign your name and spell it right every time?
Have you ever stayed sober for a whole weekend?
 
Can you count:       Past 10 with your shoes on?
                     Past 21 with your fly up?
 
Have you EVER had more than one bath in a week?        Month?
 
Medical Information (check all that apply):
()B.O.      ()Crabs          ()Head Lice     ()Bad Breath
()Scabies   ()Yellow Teeth   ()Green Teeth   ()Runny Nose
()Tattoos   ()Cross-Eyed     ()Stutter       ()Fleas
 
 
SIGNATURE (ONE X WILL DO):                                DATE:
 
________________________________________________________________
Q. How many Southern Californians does it take to change a light bulb?
A. 5.  One to call the electrician, 4 to fill out the Environmental
Impact Report.
Jokes