Name:___________________________________________________________
	Nickname:______________________ C.B. Handle_____________________
	Mobile Home Color: ( )  Two-tone, Brown and White
	                   ( )  Two-tone, Pink and White
	                   ( )  Faded Green

	Daddy: (if unknown, attach list of three suspects): _______________
	                                                    _______________
	                                                    _______________
	Mama: _____________________________________________________________

	Neck Shade: ( ) Light Red  ( ) Medium Red ( ) Dark Red
	Number of teeth in exposed full grin: Upper__________ Lower_________
	Model of pickup truck:_______________   Size of tires: _____________
	Number of beer cans on floor of pickup truck:______________________
	Truck equipped with:
	( ) Gun Rack         ( ) Mud Flaps     ( ) Camper Top     ( ) Air Horn
	( ) American Flag    ( ) 4-W Drive     ( ) 8-Track        ( ) Rust
	( ) Fuzz Buster      ( ) Roll Bar      ( ) C.B.           ( ) Mud Tires
	( ) Load of wood     ( ) Dents         ( ) Deer poaching spot light
	( ) Playboy emblem hanging from rearview mirror
	( ) Woman's garter hanging from rearview mirror
	( ) Pine tree air freshener hanging from rearview mirror

	Bumper Stickers
	( ) Honk if You're Horny	( ) Washington State Bird: Slug
	( ) Almost Heaven, Hayward      ( ) Where the Hell is Rhinelander?
	( ) Feminazi's for Kohl         ( ) Wisconsin State Bird: Mosquito
	( ) Ducks Unlimited             ( ) Walleyes Unlimited
	( ) Tommy Bartlett Water Show   ( ) Nuke Illinois
	( ) Eat Cheese or Die           ( ) Cheddarheads for Bush
	( ) The Pack is Back (on bumper since 1973, still waiting)
	( ) You'll Get My Gun When You Pry My Cold Dead Fingers From Around
	    The Barrel

	Favorite Meal:
	( ) Anything fried in lard	  ( ) Pickled pigs feet
	( ) Bratwurst and Old Milwaukee	  ( ) Venison sausage and Old Milwaukee
	( ) Cheesecurds and Old Milwaukee
	( ) Green bean and mushroom soup casserole
	( ) Slim Jims and lime Jell-o

	Favorite Music:
	( ) Country                 ( ) Western        ( ) Country Western
	( ) Anything played by an accordian

	Favorite Recreation:
	( ) Deer Huntin		    ( ) Snowmobilin
	( ) Fishin with live bait   ( ) Deer huntin while drinking
        ( ) Watching Green Acres reruns
	( ) Snowmobilin while drinking
	( ) Watchin Green Acres while drinking
	( ) Fishin with live bait while drinking

	Favorite Weapon:
	( ) .22          ( ) 30/30          ( ) 30/06            ( ) Ice auger
	( ) Chain saw    ( ) Tire iron      ( ) Forehead         ( ) Wife

	Favorite Fragrance:
	( ) Wet dogs         ( ) WD-40            ( ) Old Milwaukee
	( ) Minnow bucket    ( ) Frying Spam      ( ) Diesel fuel
	( ) A paper mill on a hot day in August
	( ) Fish guts after a week in the trash (in the garage) in August
	( ) Any scent eminating from a bodily orifice

	Favorite Cap Emblem:
	( ) Old Milwaukee   ( ) Stihl        ( ) Blatz         ( ) Skoal
	( ) Packers         ( ) Pabst        ( ) John Deere    ( ) Hamms
	( ) Brewers         ( ) Point Beer   ( ) Old Fart      ( ) Old Style

	Favorite Reading:
	( ) Fishing Facts    ( ) TV Guide         ( ) Beer Bottle labels
	( ) Enquirer         ( ) Guns & Ammo      ( ) Today's Mercenary
	( ) Polka Digest     ( ) Aryan Review     ( ) Welfare Application
	( ) Sports Illustrated (swimsuit edition only)

	Things in Your Front Yard:
	( ) Various kitchen appliances     ( ) Piles of split wood
	( ) Cars on blocks                 ( ) Dismantled snowmobiles
	( ) Dog run with all the grass worn away down to rock hard dirt
	( ) Broken, metal frame, screen gazebo
	( ) Deer hanging from tree limb--in season
	( ) Deer Hanging from tree limb--out of season
	( ) Wood cut-out of bent over woman

	Can you beat your wife at arm wrestling? ____________________________
	When was your last sighting of Elvis?: ______________________________
	Do you wear mostly polyester pant with snags?: ______________________
	Do you own any shoes? (not counting boots): _________________________
	Length of Right Leg: ____________  Length of Left Leg: ______________

	Are you married to any of the following:
	( ) Sister           ( ) Cousin             ( ) Cousin's sister

	Typical Greeting:
	( ) Good Moring, dere
	( ) Dem Packers is playing like a buncha old women
	( ) Dem Brewers is playing like a buncha old women
	( ) Dem Badgers is playing like a buncha old women
	( ) Dem Bucks is playing like a buncha old women
	( ) Dey should take da whole buncha dem Madison liberals and queers and
	    line em up and shoot em
	( ) Dey should just let dem Indians spear dose idiots at the DNR
	( ) Ya, hey

	Favorite Tavern Name:
	( ) County Trunk Bar         ( ) Dew Drop Inn
	( ) Deer Drop Inn            ( ) Deer Droppings Inn
	( ) LakeSide Supper Club     ( ) LakeView Supper Club
	( ) LakeWood Supper Club     ( ) PineSide Supper Club
	( ) PineView Supper Club     ( ) PineWood Supper Club

	Favorite Automobile:
	( ) '67 Ford Galaxy
	( ) '67 Ford Galaxy with transmission
	( ) '67 Ford Galaxy with '73 Chevy Impala transmission
	( ) '67 Ford Galaxy with '73 Chevy Impala transmission and '71 Buick
	    LeSabre engine

	Farthest Point South Ever Traveled:
	( ) County Trunk GG    ( ) County Trunk CC    ( ) County Trunk Bar
	( ) Winter             ( ) Polar              ( ) Klondike
	( ) Maple              ( ) Poplar             ( ) Birchwood
	( ) Manitowish         ( ) Namekagon          ( ) Ojibwa
	( ) Peru               ( ) Scandinavia        ( ) Athens
	( ) Irma               ( ) Helma              ( ) Loretta
	( ) Beaver             ( ) An ice shanty on the Flambeau Flowage

	Most Memorable Event You've Ever Attended
	( ) Minocqua Moose Call Competition
	( ) Phelps Mister Potato Carnival
	( ) Gleason Grouse Mating Gala
	( ) Herbster Jaycees Seagull Doo-Doo Days
	( ) Lake Tomahawk Crew Cut Championships
	( ) Ogema Outboard Motor Repair Finals
	( ) Spread Eagle International Proctologists Convention
	( ) Chetek Carp Queen Beauty Contest and Carp Cuisine Cook-Off
	( ) Eagle River Shout-Off for the Deaf (held week after the
	    snowmobile races)

	Your Signature (an X will do): _________________________________

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