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Red Neck Census Form
Last name: ________________
(Check appropriate box)
Age: ____ (if unsure, guess)
Sex: ____ M _____ F _____ Not sure
Shoe Size: ____ Left ____ Right
Spouse's Name: __________________________
Relationship with spouse:
Number of children living in household: ___
Mother's Name: _______________________
Father's Name: _______________________
Education: 1 2 3 4 (Circle highest grade completed)
Do you [_] own or [_] rent your mobile home?
Vehicles you own and where you keep them:
Firearms you own and where you keep them:
Model and year of your pickup: _____________ 194__
Number of road kills presently in your freezer?
Do you have a gun rack?
Newspapers/magazines you subscribe to:
___ Number of times you've seen a UFO
How often do you bathe:
How many teeth? ___
Brand of chewing tobacco you prefer:
How far is your home from a paved road?