STATE of PUNJAB DRIVING
LICENSE APPLICATION FORM
Last name: (Check appropriate box)
(_) Kaur
(_) Singh
(_) do not know
First name: (Check appropriate box)
(_) Balwinder
(_) Jaswinder
(_) Surinder
(_) Joginder
(_) Maninder
(_) Dont know
Age: ____
Sex: ____ M _____ F _____ not sure
Shoe Size: ____ Left ____ Right
Occupation:
(_) Farmer
(_) 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 highestgrade completed)
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
___ Number of times you've seen a UFO
___ Number of times you've seenanother person exactly like you
___ Number of times you've seenyourself in a UFO
How often do you bathe:
(_)Weekly
(_)Monthly
(_)Not Applicable
How far is your home from a pavedroad? (_)1 mile (_)2 miles (_)don't know
Do You know driving Yes No Not Sure
Do U drive Right Handed Left Handed Hath chod ke
Do not write anything in the above form.Its for Office use only