pizzanooo Posted May 5, 2010 Report Share Posted May 5, 2010 The 2010 Federal Census For The South Last name: ________________ First name: (Check appropriate box) (_) Billy-Bob (_) Billy-Joe (_) Billy-Ray (_) Billy-Sue (_) Billy-Mae (_) Billy-Jack What does everyone call you? (_) Booger (_) Bubba (_) Junior (_) Sissy (_) Other___________________ Age: ____ (if unsure, guess) Sex: ____ M _____ F _____ Not sure Shoe Size: ____ Left ____ Right Occupation: (Check appropriate box) (_) Farmer (_) Mechanic (_) Hair Dresser (_) Unemployed (_) Dirty Politician (_) Preacher Spouse's Name:_________________________ 2nd Spouse's Name:______________________ 3rd Spouse's Name:______________________ Lover's Name:___________________________ Relationship with spouse: (Check all that apply) (_) Sister (_) Brother (_) Aunt (_) Uncle (_) Cousin (_) Mother (_) Father (_) Son (_) Daughter (_) Pet Number of children living in household: _____ Number of children living in shed: ______ Number that are yours: ______ Mother's Name: _______________________(If not sure, leave blank) 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: 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 you've seen a UFO:_____ Number of times in the last 5 years 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 eyes: Left______ Right_____ Color of hair: (_) Blonde (_) Black (_) Red (_) Brown (_) White (_) Clairol Color of teeth: (_) Yellow (_) Brownish-Yellow (_) Brown (_) Black (_) N/A Brand of chewing tobacco you prefer: (_)Red-Man (_)Skoal (_)Coppenhagen How far is your home from a paved road? (_) 1 mile (_) 2 miles (_) just a whoop-and-a-holler (_) road? Link to comment Share on other sites More sharing options...
ubiquitous Posted May 5, 2010 Report Share Posted May 5, 2010 Link to comment Share on other sites More sharing options...
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