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# APICATION FOR FEDERAL EMPLOYMENTStandard Form No 57Approved April 9, 1940(Revised July 1942)U. S. CIVIL SERVICE COMMISSIONU. S. C. Dept Cir. No 3.32INSTRUCTIONS - Answer every questions artly and inmpletely. Typewriter or write leinBLACK INKto sesure clear photographycopers for appunting agencies. If you are applying for a phe United StatesCitil Service Examination, read the Examination Annancement carefully on all reties, and mail this applecation to the oth. named theirin if not, mail with an esplanatics letter withe 1S.CIVEL SERVICE COMMISSION,WASHINGTON, D.C. unless otherwne drested. Ntify same of any change id addi1.  Nume of examination, if any or name of position applies hr.2.  Place of examination (if a written test); or place of employment applied for3.  Optional sultect, if mentioned in examination an4.  Mr.    Mrs.    Miss Ann Lorene Goodpasture5.  247 Delaware AxSAA AR 308, 86.  Washington, Dr. Site ant Skate)7.  Date of birth (month, day, 8. Ago last burthday 9. Date of this application:    year).11-28-1918 25 1-194410. Logul or voting residence:    State Oklahoma11. (a) Chéck uno (b) Check ano. WidowolX.Single. Separated.Marriat... Divorced.Mulo-Fomalo.12. Where were you bom? Colina, Tennec00013. Preference:    Allowed-    Votamon    Diintulity.    Wile    Widow.    Diwalkowed    Closed14. Τοοειωτια πυπτοτε RE 7500 Ext. 71452    (Residotion phone) (Buss phone)15. Howsht, with. Worght    out stres. 5.1 11 11016.  Indian.Indicate "You" or "No" answer by placing X in einer dumn Y۰۰ No Imdinate "Yes or No" unawer by showing X in proper colution17. Are you a citizen of the United States?.    Unless otherwise instructed naturalized clone thuat sul mit,    along with this application, Naturaliration Certifivite wther foreign-    Lorn documentary proot of convenabip Documents will te zeturned.18. Have you ever been arrested, or summoned into court as a de    londant, or indicted, or convicted or hiding nanned, or    placed on probation, or hasanya namngumst puitwon filed, or have    you ever been ordered to depout collateral for allage breach of    violation of any law or roligtration or a winimerer?...    If so, list all coars, without any excerption whotawver, under liem.45. 500 4, ging in each care (1) the date (2) your age at the time.    (3) the place where the allad olfense or violations utte's, (4) the    nanio und location of the court, (3) the nature of the utlence of viola    tion, (6) the penalty, if any, impond, or other disp    Πιο πέινο    question inchides urrests hy military or naval suthewities and dis    ciplinary action imposed by courts martial as well as in civil cases.    Haperanteed your lingerprinte wille taken19. I Have you any physical defect or disability whatsover?.    tbi Have you ever had a nervous breakshown?    If your ror.swer to either (u) or (h) is you, give full particulare under    Item 45, trig 420. Do you advocate or have you ever advented or are you now    er have you ever bean a member of any organisation that advo    cates the overthrow of the Government of the United States by force    or violence.    It so give complete datails under Item 45.21. Have you ever be on discharged for misconduct or unsated ictory    servire, er forand to rosnja from any position?    the    Il so, atate (under Item 45) when and where empleyst and give t    name and address of your employer and the reason for your 28-    charye or forced resignation in each case22. Within the past 12 months, have you used intonating beverages?    it so, spoly:Occasionally Habitually. To exons23. Are any members of your family or relatives (either by land or    by marriage), einsaluyent by the United States Caverumel, ex-    clurting persons in the armed forces?.....    4    ila, give name, aktress, anlationship, and branch of service of    each such relative under Item 4524. Are you NOW employed by the Federal Government?(a) Ito War Eelocation Authority Barr. Fuilding, Washington, D.C..(b) If you now are ar have ever been so employed give dates:from (Month) 19. (Year)25. (a) Wero you ever in the II. S military or naval    It so give branch of service and date of last Jiach    Artay. Navy. Marine. Crist Guard. Date(b) Were all diacharmes granted under honoimble andtons?(el. Have you already ostalihet mirary praterence with the(vil Service CommIf an check bind preleronce below.Veteran. Danbied. Wite of disabled Widow ofтраIl you are arplying for a specific eenmirvinen, and wish wskumvelemn svehemence in connection with it, attach CSC PrebecForm 14 Aether with the evidence sales therein26. Have you registered under the Selective Service Acti..    Itoa e akiress and number of local board.27. It chussuhed qινο Your verder number.28. (a' Are you now a member of any tranch of military of aaral    COMMENT29. Of crganization.(3) Are you now on active duty?..30. Give number of persons completely dependent on you, other than    busand or none31. Would you accept short term oppointmar.t?,    3 months I arinth32. (a) Wald you owept appointment anywhere offered in the    United States    Give Location pretorence(b) Word you accept appointment outside the United StatesGirmations(c) you arement in WDItem and its are applying for detecezummation announcement to sew attente of ReC.S C F 12 is to be submitted Prort of reedence is dfor many kinds of powih.vis33. What is the lowest entrance salary you will accept? 5.    100000 2000-yr.34. You will not be considered for puutions paying leas. per35. If you are willing to travel city Ovazionally Frequently.36. How much notice will you require to report for work? 1-40002-0