NAVAJO RESERVATION DRIVER'S LICENSE APPLICATION
First Name________________
Last Name:
( ) Atcitty
( ) Begay
( ) Begaye
( ) Benally
( ) Nez
( ) Yazzie
Age:____(if unsure, guess)
Sex:____M______F_______Not sure
Shoe Size:______Left______Right
Tribal Clothing Jacket Size:________
Occupation:
( )Spring Sheepherder
( )Summer Sheepherder
( )Fall Sheepherder
( )Winter Sheepherder
( )Unemployed
( )Dirty politician
Spouse's Name:________________
2nd Spouse's Name:______________
3rd Spouse's Name:____________
Relationship with spouse:
( )Best friend's wife
( )Best friend's sister
( )Don't remember
( )It just happened
( )Which one....
Lover's Name:___________
2nd Lover's Name:___________
Number of children living in household:_____
Number of children living in shed:________
Number of children that are yours:_________
Mother's Name:________
Father's Name:_________
(if not sure, leave blank)
Education:1st; 2nd; 3rd; 4th (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
___Number of vehicles with a water tank
Firearms you own and where you keep them:
___truck
___bedroom
___outhouse
___kitchen
___shed
Model and year of your pick-up:___________ 194_
Do you have a gun rack?
( )Yes ( ) NO; If no, please explain:
Newspapers/magazines you subscribe to:
( ) Navajo Times
( ) Gallup Independent
( ) Navajo/Hopi Observer
( ) Buckle Bunnies
( ) NFR
___Number of times you've seen a Navajo Nation
president
___Number of times you've seen a NN president with a
woman
___Number of times you've seen a NN president with
numerous women
How often do you bathe:
(if no running water, you may still respond)
( )Weekly
( )Monthly
( )Not Applicable
Color of teeth:
( )Yellow
( )Brownish-yellow
( )Brown
( )Black
( )N/A
Brand of alcohol you prefer:
( )T-Bird
( ) G-D
How far is your home form a paved road?
( )1 mile
( )2 miles
( )don't know
