STATE OF KENTUCKY RESIDENCY APPLICATION

Star InactiveStar InactiveStar InactiveStar InactiveStar Inactive
 
Name: ________________  (_) Billy-Bob
           (last)        (_) 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)

  
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
  (_) 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