APPLICATION FOR ARKANSAS DRIVERS LICENSE

Last name: __________________________
First name: (Check appropriate box)
[_] Billy Bob       [_] Bobby-Sue
[_] Billy Joe       [_] Bobby-Jo
[_] Billy Ray       [_] Bobby-Ann
[_] Billy Sue       [_] Bobby-Lee
[_] Billy Mae       [_] Bobby-Ellen
[_] Billy Jack           [_] Bobby-Beth

Age: ____ (if unsure, guess)
Sex: ____ M      _____ F  _____ Not sure

Shoe Size: ____   Left    ____ Right

Occupation:
[_] Farmer               [_] Mechanic
[_] Hair Dresser         [_] Waitress
[_] Unemployed      [_] Dirty Politician

Spouse's Name: __________________________
2nd Spouse's Name: _______________________
3rd Spouse's Name: _______________________
Lover's Name: ____________________________
2nd Lover's Name: ________________________
Relationship to spouse:
[_] Sister          [_] Aunt
[_] Brother         [_] Uncle
[_] Mother          [_]  Son
[_] Father          [_] Daughter
[_] Cousin          [_]  Pet

Number of children living in household: ___
Number of children living in shed: ___
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

Where you keep them firearms:
____ truck               ____ kitchen
____ bedroom        ____ bathroom
____ shed

Model and year of your pickup:
____________   194_
Do you have a gun rack?  [_] Yes [_] No; If no,
please explain:___________________________

Newspapers/magazines you read:
[_] The National Inquirer           [_] 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

Color of teeth:
[_] Yellow          [_]  Brownish-Yellow
[_] Brown            [_]  Black
[_] N/A             [_]  Have Teeth?

Brand of chewing tobacco you prefer:
[_] Red-Man
[_] Other

How far is your home from a paved road?
[_] 1 mile
[_] 2 miles
[_] Don't know
[_] Paved Road?