Arkansas State residency application page2

Nespapers/magazines that you subscribe to
(_)Weekly world News
(_)National Enquirer
(_)TV Guide
(_)Soap Opera Digest
(_)The Globe
(_)Weekly Elvis Report
(_)Cant read, someone else is filling this out
( Check all that apply)

Number of time you have seen a UFO_____
Number of time you have seen Elvis_______
Number of time you seen Elvis in a UFO____

How often do you Bathe
(_)Weekly
(_)Monthly
(_)Not Applicable

Color Of Teeth
(_)Yellow
(_)Green
(_)Black
(_)Brown
(_)Non

Brand of Chewing Tabbacco
(_)Redman
(_)Big Legue
(_)Coppenhagen
(_)Homemade

What kind of whisky do you drink
(_)Jack Daniels special
(_)Super Shine
(_)Telmer
(_)Dinoquerval special
(_)Homemade Shine
(_)Relative shine

How do you get you Whisky/Beer
(_)Store-Buy it
(_)Store-Steal it
(_)Store-friend/relitive works there gets it to you
(_)Make it at home
(_)Friend or family member makes it
(_)Steal it from friend or family member
(_)Sell you body for it
(_)Bartering(Trading one thing for Whisky)

How Far from a paved road do you live
(_)1 mile
(_)2 miles
(_)3 Miles
(_)3-10 Miles
(_)More than 10
(_)Dont Know

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