Kentucky

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STATE OF KENTUCKY RESIDENCY APPLICATION FORM

Name: ______________ (last)

First:(Please tick appropriate box)

Billy-Bob [ ]
Billy-Joe [ ]
Billy-Ray [ ]
Billy-Sue [ ]
Billy-Mae [ ]
Billy-Jack [ ]

Shoe size: ______ (left) ________ (right)

Occupation:

Farmer [ ]
Mechanic [ ]
Hair Dresser [ ]
Unemployed [ ]

Relationship with spouse:

sister [ ]
brother [ ]
aunt [ ]
uncle [ ]
cousin [ ]
mother [ ]
father [ ]
son [ ]
daughter [ ]
pet [ ]

Education: 1 2 3 4 (tick highest grade completed)

Do you own [ ] or rent [ ] your mobile home?

___ 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 pick-up: __________194__

Do you have a gun rack? [ ]yes [ ]no. (If no, please explain)

___ number of times you've seen Elvis
___ number of times you've seen a UFO
___ number of times you've seen Elvis in a UFO

How often do you bathe:

weekly [ ]
monthly [ ]
N/A [ ]

Colour of teeth:

yellow [ ]
brownish-yellow [ ]
brown [ ]
black [ ]
N/A [ ]

How far is your home from a paved road:

1-5 miles [ ]
5-10 miles [ ]
don't know [ ]




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