Bill Clinton, GovernorAPPLICATION TO LIVE IN ARKANSAS

Name:___________________________________________________________________________Nickname:___________________________________CB Handle:__________________________Daddy (if unknown attach list of 2 suspects):___________________________________NECK SHADE:( ) Light Red   ( ) Medium Red   ( ) Dark Red  ( ) Other:_______Number of teeth exposed in full grin:____________Upper:_________Lower:__________Make of Pickup:___________________________________Size of tire:_________________HOUNDS:__________   TYPE:  ( ) Blue Tick  ( ) Beagle  ( ) Black & Tan  ( ) OtherLength of Right Leg:________________________Length of Left Leg:_________________How Many cars/makes in front yard?________________How many on blocks?___________How Many kitchen appliances on front porch?_______________Back porch?___________When and where was your last "ELVIS" Sighting?__________________________________Do you wear mostly polyester pants with snags?   ( ) YES   ( ) NO
Do you own any shoes(Not boots)?    ( ) YES   ( ) NO
Are you married to any of the following(Circle all that apply): Sister  Cousin
Cousin's Sister   Aunt   Other, Explain:________________________________________Does your wife weigh more than your pickup?  ( ) YES   ( ) NO
Can you sign your own name and always spell it right?   ( ) YES  ( ) NO
Have you EVER had more than one bath in a week?  ( ) YES   ( ) NO, Explain:_____
MEDICAL INFORMATION:
Do you have atleast two(2) of the following?: ( ) B.O. ( ) Crabs ( ) Lice
( ) Bad Breath ( ) Scabies ( ) Fleas ( ) Tatoos ( ) Crossed Eyes ( ) Runny Nose
( ) Green Teeth ( ) Brown Teeth ( ) Yellow Teeth ( ) Any Teeth ( ) Number of
Teeth Missing:__________________________________________________________________
GENERAL INFORMATION:
Can you count past ten with your shoes on?  ( ) YES ( ) NO
Past 21 with your fly up? ( ) YES ( ) NO
Favorite Weapon: ( ) Tire Iron ( ) Pick Handle ( ) Log Chain ( ) Shotgun
Favorite Pastime: ( ) Drinkin' ( ) Coon Huntin' ( ) Fishin' ( ) Other:__________Truck Equipped with: ( ) Gun Rack ( ) Fuzzbuster ( ) 8 Track ( ) Rebel Flag
( ) Roll Bar ( ) C.B. Radio ( ) Beer Cans ( ) Squirrel Tail
Favorite Vocalist ( ) Willie Nelson ( ) Johny Cash ( ) Elvis ( ) Conway Twitty
( ) Loretta Lynn
Bumper Stickers: ( ) Honk if you LOVE Jesus ( ) Dial 1-800-Eat Shit ( ) Old Fart( ) Dig Clams
Cap Emblems: ( ) John Deere ( ) CAT ( ) SKOAL ( ) Budweiser ( ) Jack Daniels
Memberships: ( ) NRA ( ) VFW ( ) KKK ( ) 700 Club ( ) B.P.O.E.
Your Signature (one X will Due):__________________________Date:________________