RESIDENCY APPLICATION FOR
THE STATE OF KENTUCKY

First Name: _____________ 
Last Name: (CHECK APPROPRIATE BOX) 
(_) Billy-Bob 
(_) Billy-Joe 
(_) Billy-Ray 
(_) Billy-Sue 
(_) Billy-Mae 
(_) Billy-Jack
  
Age: ____ 
Sex: ____ M ____ F _____ N/A 
Shoe Size ___ Left ___ Right 
Occupation: 
(_) Farmer 
(_) Mechanic 
(_) Hair Dresser 
(_) Un-employed 
Spouse name: _________________
Spouse 2 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