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> THE 2000 FEDERAL CENSUS FOR THE SOUTH > > Last name: ________________ > First name: (Check appropriate box) > (_) Billy-Bob > (_) Billy-Joe > (_) Billy-Ray > (_) Billy-Sue > (_) Billy-Mae > (_) Billy-Jack > > What does everyone call you? > (_) Booger > (_) Bubba > (_) Junior > (_) Sissy > (_) Other___________________ > > Age: ____ (if unsure, guess) > > Sex: ____ M _____ F _____ Not sure > > Shoe Size: ____ Left ____ Right > > Occupation: (Check appropriate box) > (_) Farmer > (_) Mechanic > (_) Hair Dresser > (_) Unemployed > (_) Dirty Politician > (_) Preacher > > Spouse's Name:_________________________ > > 2nd Spouse's Name:______________________ > > 3rd Spouse's Name:______________________ > > Lover's Name:___________________________ > > Relationship with spouse: (Check > appropriate box) > (_) Sister > (_) Brother > (_) Aunt > (_) Uncle > (_) Cousin > (_) Mother > (_) Father > (_) Son > (_) Daughter > (_) Pet > > Number of children living in household: _____ > Number of children living in shed: ______ > Number that are yours: ______ > > Mother's Name: _______________________(If > not sure, leave blank) > > 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: 196_ > > Do you have a gun rack? > (_) Yes (_) No; If no, please explain: > > Newspapers/magazines you subscribe to: > (_) The National Enquirer > (_) The Globe > (_) TV Guide > (_) Soap Opera Digest > (_) Rifle and Shotgun > > Number of times you've seen a UFO:_____ > > Number of times in the last 5 years 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 eyes: > Left______ Right_____ > > Color of hair: > (_) Blonde > (_) Black > (_) Red > (_) Brown > (_) White > (_) Clairol > > 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 > (_) just a whoop-and-a-holler > (_) road? > > ______________________________________________________ > Get Your Private, Free Email at http://www.hotmail.com > > > > > > > > > > > > > >