Arkansas Driver's License Application

Last name: __________________________
First name: (Check appropriate box)
[_] Billy-Bob
[_] Billy-Joe
[_] Billy-Ray
[_] Billy-Sue
[_] Billy-Mae
[_] Billy-Jack
[_] Bobby-Sue
[_] Bobby-Jo
[_] Bobby-Ann
[_] Bobby-Lee
[_] Bobby-Ellen
[_] Bobby-Beth

Age: ____ (if unsure, guess)
Sex: ____ M _____ F    _____ Not sure
Shoe Size:    ____   Left ____ Right

Occupation:
[_] Farmer
[_] Mechanic
[_] Hair Dresser
[_] Waitress
[_] Dirty Politician
[_] Unemployed

Spouse's Name: __________________________
2nd Spouse's Name: _______________________
3rd Spouse's Name: _______________________
Lover's Name: ____________________________
2nd Lover's Name: ________________________

Relationship to spouse:
[_] Sister
[_] Aunt
[_] Brother
[_] Uncle
[_] Mother
[_] Son
[_] Father
[_] Daughter
[_] Cousin
[_] Pet

Number of children living in household: ___
Number of children living in shed: ___
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

Where you keep them firearms:
____ truck
____ kitchen
____ bedroom
____ bathroom
____ shed
____ all of the above

Model and year of your pickup:  ___________   194 _

Do you have a gun rack?
[_] Yes [_] No; If no, please explain:___________________________

Newspapers/magazines you read:
[_] 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
[_] Teeth?
[_] N/A

Brand of chewing tobacco you prefer:
[_] Red-Man
[_] Other

How far is your home from a paved road?
[_] 1 mile
[_] 2 miles
[_] don't know
[_] paved road?

Place your "X" here ________.
Return this form to the clerk.  Thank yew.

 

 

 

 

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