These are always fun:
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West Virginia Residency Application
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APPLICATION TO LIVE IN THE STATE OF WEST VIRGINIA
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1. Your name is (Check one):
( ) Billy ( ) Calvin ( ) Eli ( ) Harvey
( ) Homer ( ) Jimmie ( ) Junior ( ) Leonard
( ) Leroy ( ) Luther ( ) Oscar ( ) Mordechai
a. Nichname:___________________ b. CB Handle:_______________________
2. Address (RFD#):________________________________________________________
3. Daddy (If unknown, attach list of 3 suspects):_________________________
4. Mama:______________________ 5. Number of brothers/sisters_____________
6. Are you married to: ( ) Sister ( ) Cousin ( ) Sow ( ) Other Relative
Do you know her name?__________________________________________
Does your wife weigh more than your truck? ( ) Yes ( ) No ( ) Likely
7. Number of weeks employed:_________ On welfare:________ in the last year.
8. Your neck shade (check one): ( ) Light red ( ) Medium red ( ) Dark red
9. Number of dependents: (Legal)___________ (Claimed) _____________________
10. Length of Right Leg:_______ inches. Lenght of Left Leg:________ inches.
11. Type of pick-up owned:_________________________________________________
a. Year:____________ b. Height of Truck__________________________
c. Is any portion of your truck painted primer red (The official state
color)?_________ What part(s)?________________________________
d. Average number of beer cans on floorboards of pick-up
truck:_________________________________________________________
e. Truck equipped with (check all that apply):
( ) Gun rack ( ) 4-wheel drive ( ) Eight Track ( ) Load of wood
( ) Big dog ( ) Fuzz buster ( ) Mag wheels ( ) Dual CB Antenna
( ) Camper Top ( ) Spitoon ( ) Mud flaps ( ) Spit Staines
( ) Bumper hitch ( ) Spit stains ( ) Air horns ( ) Hijacker shocks
( ) Raccoon Hide ( ) Deer Antlers ( ) Confederate flag
. Bumper stickers on truck (regardless of location):
( ) Eat More Possum ( ) Redman Chewing Tobacco
( ) Honk if your love Jesus ( ) Honk if your Horny
( ) Elvis is Alive ( ) My Other car is a piece of s---, too
( ) BOCEPHUS ( ) Get off my Ass
( ) Other:____________________________________________________________
12. Weapons owned:
( ) Deer Rifle ( ) Scatter Gun ( ) Log Chain ( ) Sawed-off shotgun
( ) Balin' Hook ( ) Varmit Rifle ( ) Axe Handle ( ) Tire Iron
a. Which are normally carried on your person?__________________________
b. In your truck?______________________________________________________
13. Favorite Recreation:
( ) Drankin' ( ) Possum Huntin' ( ) Bull Chip Throwin'
( ) Craw Daddin' ( ) Four Wheelin' ( ) Gospel Sangin'
( ) Skinny Dippin' ( ) Fightin' ( ) Fishin'
( ) Puckin' ( ) Spittin' Backy ( ) Square dancin'
14. Emblem on your favorite cap:
( ) CAT ( ) NAPA ( ) Budweiser ( ) McCullough
( ) Coors ( ) John Deer ( ) P. B. R. ( ) Skoal
15. Define the following (must be 90% correct):
a. brogans - ____________________________________________
b. chitlins - ____________________________________________
c. cobbler - ____________________________________________
d. fatback - ____________________________________________
e. goobers - ____________________________________________
. collards - ____________________________________________
g. grits - ____________________________________________
h. muscadina - ____________________________________________
i. pig skins - ____________________________________________
j. pinto beans - ____________________________________________
k. poke - ____________________________________________
l. redeye gravy - ____________________________________________
n. s--- on a shingle - ____________________________________________
o. sidemeat - ____________________________________________
p. soppin' syrup - ____________________________________________
q. spam - ____________________________________________
r. taters - ____________________________________________
s. tote - ____________________________________________
t. turnip salad - ____________________________________________
16. Favorite Sanger:
( ) Donna Fargo ( ) Conway Twitty ( ) Jonny Cash
( ) Elvis (mandatory) ( ) Hank Junior ( ) Loretta Lynn
( ) Porter waggoner ( ) Willie Nelson ( ) George jones
( ) Slim Whitman ( ) Tammy Wynette ( ) Boxcar Willie
17. Club Memberships:
( ) K.K.K. ( ) N.R.A. ( ) 700 Club
( ) P.T.L. ( ) Four H ( ) B.A.S.S.
( ) Sons of the confederacy (mandatory)
18. Number of dogs owned (Do not include kinfolk):______________________
Type: ( ) Blue Tick ( ) Beagle ( ) Redbone ( ) Black 'n' Tan ( ) Mutt
19. Number of cars on block in front yard:_________________________________
20. How many kitchen appliances do you keep on your front porch?____________
How many of them work?_____________________
21. Do you wear: ( ) snagged polyeter pants ( ) denim britches ( ) shorts
22. Do you own any shoes? ( ) Yes ( ) No If so, hom many?_____________
Year you last bought shoes:__________________________
23. Highest grade completed in school: _______________ If higher than 8th
grade, reason why:___________________________________________________
24. Can you sign your name and spell it correctly every time?
( ) Yes ( ) No ( ) Maybe
25. Do you know any words that have more than four letters?
( ) Yes ( ) No
If so list them here:___________________________
26. Have you ever had more than one bath in a week? ( ) Yes ( ) No
( ) What's a bath
27. Can you count past ten with your shoes on? ( ) Yes ( ) No
( ) never tried
...past twenty with your fly up? ( ) Yes ( ) No
( ) never tried
28. What do you prefer to drink?
( ) Iced tea ( ) Budweiser ( ) Everclear
( ) Mad Dog 20/20 ( ) Jack daniels ( ) Boones's farm
( ) Jim Beam ( ) Rotgut Moonshine ( ) Coors
29. Have you ever stayed sober for a whole weekend? ( ) Yes ( ) No
If so, why?_____________________________________________________
30. Medical Information:
a. Do you have any of the following? (check all that apply):
( ) trench mouth ( ) bad breath ( ) crotch crickets
( ) body odor ( ) runny nose ( ) head lice
( ) missing front teeth ( ) obvious warts ( ) crabs
b. Do you show any of the following classic signs of inbreeding?
Check all that apply (Minimum three required):
( ) Closely-set eyes ( ) Misaligned ears ( ) Hairs Shoulders
( ) Vacant Stare ( ) Low Forehead ( ) Slight Limp
( ) Slack Jaw ( ) Speech Impediment ( ) IQ of a Carrot
I certify that the above information is true and correct to the best of my
knowledge.
Signature ("X" must be witnessed): _____________________________________
Witness (if "X" is used): _____________________________________
Today's Date (if known): _____________________________________
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