Name:______________

       CB Handle:___________

       Neck shade:
       _____Light Red
       _____Medium Red
       _____Dark Red

       Number of teeth in exposed full grin:  (Neither can exceed 3)
       Upper______
       Lower______

       Mobile home color:
       ______Two-tone, brown & white
       ______Two-tone pink & white
       ______ Faded green

       Model of Pickup Truck:____________
       Size of Tires:__________________
       Length of right leg:______________
       Length of left leg:_______________

       Note: To be accepted, you must be honest and you must be able to check
       at least 20 items  from the questions below.

       Note that good Packer fans can sometimes check many answers for some
       of the questions.

       1. I am in love with:
       ___My right hand
       ___My left hand
       ___Both hands

       2. My favorite music:
       ____Country
       ____Western
       ____Anything played on the accordian


       3. My favorite meal:
       ____Head cheese & Old Milwaukee
       ____Venison sausage and Old Milwaukee
       ____Cheese curds and Old Milwaukee

       4. Preferred weapon:
       ___12 Gauge
       ____Tire Iron
       ____Forehead
       ____Chain Saw
       ____ Ice Auger

       5. Primary auto:
       ____'67 Ford Galaxy
       ____'67 Ford Galaxy with transmission
       ____'67 Ford Galaxy with '73 Impala Tranny
       ____'67 Ford Galaxy w/ '73 Impala Tranny and
                      '71 Buick Wagon Engine

       6. I usually greet people by saying:
       ___Ya hey dare
       ___Dem Packers is playing like a bunch a old women
       ___Dey shouls take da whole bunch a dem der madison liberals
          and just lineem up and shootem

       7. I can count to:
       10__
       20__ If I take me boots off
       21__ If i'm neked!

       8. I bought part of the "frozen Tundra"
       ___Yes
       ___ No... but I wish I woulda

       9. Favorite Reading:
       ___Fishin Facts
       ___Beer bottle labels
       ___Guns and Ammo
       ___Today's Mercenary
       ____Polka DIgest

       10. Thinkgs in my front yard:
       ____Various kitchen appliances
       ____Car on blocks
       ____Transmissions
       ___Deer hanging from tree limb ( in season)
       ___Deer hanging from tree limb ( out of season)

       11. I mostly wear:
       ___Polyester pants w/ snags
       ___Polyester pants w/ holes
       ___Green Bay belt Buckle

       12. My favorite colors are:
       ___Green
       ___Gold
       ___I'm color blind.....except when I got me beer goggles on!!

       13. The most memorable event I ever attended was:
       ___Minoqua Moose Call competition
       ___Omega Outboard motor repair finals
       ___Lake Tomahwk Crew cut championships

       14. Favorite entertainment:
       ___Fishin while drinkin
       ___Snowmobilin while drinkin
       ___Watching Green Acres while Drinkin

       15. Pick one:
       ___ Someone is helping me read this
       ___ Someone is reading this for me.

	16. Favorite phraze:
       ___ "Gollee jeez."
       ___ "Ya d-o-n't seh?" ("You don't say?")
       ___ "Ya betcha."
       ___ "Okee-dohkee."

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