THE BEST ONE ON SURDS.

STATE of PUNJAB DRIVING LICENSE APPLICATION FORM

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Last name: (Kaur/Singh/do not know)

First name: (Check appropriate box)

 (_) Balwinder

 (_) Jaswinder

 (_) Surinder

 (_) Joginder

 (_) Maninder

 (_) Dont know

Age: ____

  ( ) Don't know

Sex: ____ M _____ F _____ not sure

Shoe Size: ____ Left ____ Right

Occupation:

(_) Farmer

(_) Truck Driver

(_) Mechanic

(_) Pehelwan

(_) House wife

(_) Un-employed

Spouse's 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; If no, please explain:

_____________________________________________

Newspapers/magazines you subscribe to:

 (_) Champak

 (_) Indrajal

 (_) Star and style

 (_) The great Punjab Dairy

 (_) Blank sheets

 (_)Weekly

 (_)Monthly

 (_)Yearly

 (_)Not Applicable

Color of teeth:

 (_)Yellow

 (_)Brownish-Yellow

 (_)Brown

 (_)Black

 (_)N/A

Brand of chewing tobacco you prefer: (_)Manikchand

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