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State of Arkansas - Residency Application
Vota que te ha parecido
Actual: 2,00/5 (1 votos)
Name: ________________
(last)
(_) Billy-Bob
(_) Billy-Joe
(_) Billy-Ray
(_) Billy-Sue
(_) Billy-Mae
(_) Billy-Jack
(Check appropriate box)
Age: ____

Sex: ____ M _____ F _____ N/A

Shoe Size: ____ Left ____ Right

Occupation:
(_) Farmer
(_) Mechanic
(_) Hair Dresser
(_) Un-employed

Spouse's Name: __________________________

Relationship with spouse:
(_) Sister
(_) Brother
(_) Aunt
(_) Uncle
(_) Cousin
(_) Mother
(_) Father
(_) Son
(_) Daughter
(_) Pet

Number of children living in household: ___

Number that are yours: ___

Mother's Name: _______________________

Father's Name: _______________________ (If not sure, leave blank)

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

Can you count to 21 and keep your fly up? (_)yes (_)no

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: _____________ 194_

Do you have a gun rack?
(_) Yes (_) No; please explain:

Newspapers/magazines you subscribe to:
(_) The National Enquirer
(_) Weekly World News
(_) 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

Brand of chewing tobacco you prefer:
(_) Red-Man

How far is your home from a paved road?
(_) 1 mile
(_) 2 miles
(_) don't know




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