>                   Application to Live in West Virginia
>
>
>Name:__________________________ Nickname:_________________________________
>
>CB Handle:_____________________
>
>Address (RFD No.):_________________--_____________________________________
>
>Daddy (If unknown, list 3 suspects):______________________________________
>
>Mamma:_________________________
>
>Neck Shade:     _____Light Red       _____Medium Red       _____Dark Red
>
>Number of teeth exposed in full grin:       Upper_____     Lower_____
>
>Name of Pickup owned:_______________ Height of Truck__________
>
>Truck equipped with:
>____Gun Rack            ____4-Wheel Drive       ____Confederate Flag
>____Cassette Deck       ____Load of Wood        ____Hijacker Shocks
>____Radar Detector      ____Mag Wheels          ____Dual CB Antennas
>____Spittoon            ____Camper Top          ____Air Horns
>____Mud Flaps           ____Toothpick Holder    ____Mud-Grip Tires
>____Raccoon Hide        ____Big Dog
>
>Number of empty beer cans on floorboard or in bed of pickup truck:_____
>
>BUMPER STICKERS:
>____Eat more Possum             ____My other car is a piece of shit too
>____Honk if you love Jesus      ____If you ain't a cowboy you aint shit
>____Redman Chewing Tobacco
>
>Define the following (must be 90% correct):
>1. Grits        6. Sawmill Gravy        11. Cobbler     16. Tater
>2. Goobers      7. Turnip Salad         12. Fatback     17. Pig Skins
>3. Pinto Beans  8. Shit-on-a-Shingle    13. Tote        18. Okrie
>4. Collards     9. Redeye Gravy         14. Chickin' Fry19. Shonuf
>5. Sidemeat     10. Soppin' Syrup       15. Poke        20. Chitlins
>
>Favorite Vocalist:
>____Reba McEntire       ____Conway Twitty       ____Loretta Lynn
>____Hank Williams Jr.   ____Randy Travis        ____Ray Wylie Hubbard
>____Tammy Wynette       ____Slim Whitman        ____Porter Wagoner
>____Willie Nelson       ____George Jones        ____Box Car Willie
>
>Favorite Recreation:
>____Square Dancin'      ____Possum Huntin'      ____Skinny Dippin'
>____Craw Daddin'        ____Gospel Singin'      ____4-Wheelin'
>____Drankin'            ____Spittin' Backy      ____Bill Chip Throwin'
>____Honky Tonkin'       ____Noodlin'            ____Other
>
>Name of Son(s):   ____Bubba   ____Jim Bob    ____LeeRoy   ____J.D.
>
>Name of Daughter(s):  ____PammySue   ____Violet   ____Paulette   ____Daisy
>
>Weapons Owned:
>___Deer Rifle   ___Sawed-Off Shotgun    ___Varmint Rifle ___Log Cabin
>___Tire Iron    ___Power Chain Saw      ___Pick Handle   ___Hick'ry Switch
>
>Number of Dogs:____    Type:    ___Blue Tick    ___Beagle
>                                ___Black & Tan  ___Bird Dawg
>
>Cap Emblem:     ___John Deer    ___McCullock Chain Saws ___Budweiser
>                ___Vo-Tech      ___Skoal                ___Coors
>                ___NAPA         ___Smile if You're Not Wearing Underwear
>
>Number of Dependents:    Legal:________         Claimed:_________
>
>Number of Weeks Unemployed:__________
>
>Number of Welfare Checks Received:____________
>
>Memberships:
>___KKK          ___NRA          ___Moose        ___PTL Club     ___AA
>___Bass Club    ___VFW          ___Quiltin' Bee ___American Legion
>___United Sons n' Daughters of the Confederacy
>___John Birch Society
>
>Length of Right leg:________            Length of Left leg:__________
>
>Does your truck contain some part painted the offical state color of
>Primer Red?  ___Yes    ___No
>
>How many cars do you have jacked up on blocks in your front yard?_______
>
>How many kitchen appliances will you keep on your front porch?__________
>
>Will you wear mostly double-knit polyester pants with snags?____________
>
>Do you own any shoes?   ____Yes    ____No    If yes, how many?__________
>
>What year did you last purchase shoes?_________________
>
>Are you married to any of the following:
>____Sister      ____Cousin      ____pig
>
>Do you know her name?________________
>
>Does your wife weigh more than your pickup?____________
>
>Can you sign your name and get the spelling right every time?____________
>
>Have you ever stayed sober for a whole weekend?________________
>
>If so, why?______________________________________________________________
>
>Can you count:  Past 10 with your shoes on?_________________
>
>Do you know any words that have more than four letters?__________________
>
>Have you ever had more than one bath in a week?__________________________
>
>Medical Information:
>Do you have at least two of the following:
>___BO           ___Head Lice    ___Rabies
>___Trench Mouth ___Runny Nose   ___Bad Breath
>
>
>IF YOUR APPLICATION IS TURNED DOWN BY THE STATE OF WEST VIRGINIA, YOU MAY BE
>ELIGIBLE IN THE STATE OF ALABAMA. THEIR STANDARDS ARE SLIGHTLY LOWER.
>HOWEVER, YOU WOULD STILL BE ABLE TO VISIT WEST VIRGINIA.