Redneck Census Form!

The official year 2000 Redneck Census Form:

Last name: _______________________

First name: (Check appropriate box)







What does everyone call you?






Age:____ (if unsure,guess)

Sex:____ M ____ F ____Not sure

Shoe size:____ Left ____ Right

Occupation:(Check appropriate box)



(_)Hair Dresser


(_)Dirty Politician


Spouses Name:_____________

2nd Spouses Name:_______________

3rd Spouses Name:_______________

Lovers Name:_______________

Relationship with spouse:(Check appropriate box)











Number of children living in the home:_____

Number of the children living in the shed:_____

Number that are yours:_____

Mothers Name:____________________(If not sure, leave blank)

Fathers Name:____________________(If not sure, leave blank)

Education: 1 2 3 4 (Circle highest grade commpleted)

(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 the back yard:___

Number of vehicles on cement blocks:___

Firearms you own and where you keep them:






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 youve seen a UFO:_____

Number of times in the last 5 years youve seen Elvis:___

Number of times youve seen Elvis in a UFO:____

How often do you bathe?



(_)Not Applicable

Color of eyes:

Left_____ Right_____

Color of hair:







Color of teeth:







Brand of chewing tobacco you prefer:


How far is your home from a paved road?

(_)1 mile

(_)2 miles

(_)just a whoop-and-a-holler


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