[104-10195-10002.pdf — page 92]
# A. PREVIOUS POSITION - POSTE ANTERIEUR|                                                                                                                       || --------------------------------------------------------------------------------------------------------------------- || Dates of employment - Durée d'emploi From May 1952 To Fecruary 1968                                                   || Annual salary - Traitement annuel: Beginning $10,000 + profits Find: $19,000 + profits                                || Exact title of your position and place of work (London, Paris)                                                        || Europes: Editorial serresentative                                                                                     || Name of employer - Nom de l'employeu Conover-Masit Fublications, Inc                                                  || Type of work Genre d'activité Specialized periodical press                                                            || Name and title of your immediate supervisor 1. aperty. Nom et titre de votre serveur direct Exec Vice Pres (deceased) || Reason for leaving Cause de départ Promotion                                                                          |Established, planned, diructed and managed activities of overdens editorial bureau of medium-sized.publishing fire specializing in the applied bejercès, industrial management methode and technology, and marketing methous Engažinės,C. If opplicable, give here a brief resumé of emp'oyinent(s) he'd before those covered above.Si vous le juger utile, résumez ici vos divers en.plous entericurs.1960-2. Free-lance technical editor, various publishing nounes, New York1950-2 Suporvicing Technical Editor, Scientific Group, Office of the Chief of Staff, US Army1955-60 Supervi in Forfairs Specialist, Mutualat ye, Jipar A.stance frocream,1950-4 Regional. Editor, International Fresa section, be tormation Agency1949 Reporter, then associate editor, weekly newspaver chain, Faltimore.13. REFERENCES: Lut three persons not related to you by blood er marriage, who are lansiliar with your character and qualifications. Do not repeat names Inted in item 19.REFERENCES: Indiques trois personnes (parents et ollits exclus) povert donner sur vos des renseignements durdic moral et professionnel. Ne réfetez pas de nummscizes dans la case 19.| Name - Nom            | Full address - Adresse compiste                                      | Profession    || --------------------- | -------------------------------------------------------------------- | ------------- || Prof AIGRAIN Fierre   | DORST, Ministère de la Recherche Industrielle et Scientificue, Faris | Civil Lervant || Hr VICENEY Nicholas   | Science Editor, LE MONDE, rue des Italiens Paris                     | Journalist    || Prof THUILLIER Pierre | University of Paris, Nanterre Campus, Faris                          | Educator      |21. Have you any objection to our making enquiries of your present employer?    Veyez-vous queique inconvenient d ce que nous prenons des renseignements auprès de vetre empluyeur actuel?yes noQUI Z22. Sta bi chiy any other relevant facts. Include internation regalura any res dence in the country of which you are a citizen    revertement cred veti con dature DForeign residence: Canada 1937-42; UK, France, ielgium, Germany, 1944-5 (military service); Japan, 1946-8 (military service), 1955-60; France, 1962-present23. I cority shes the stessments made by me in answer to the foregoing questions are true and compiace I understand that willel misrepresentation renders me labi s esrand, of EmployedJa corpo que les reparace que j'ai faites ous coctions indessus est compities of ecoctre. Je recommendment une indication incresite, je me rendras possible de παντού επισύνη seras engagé.SignatureDate November 30, 1971You may be remoced to supply documentary evidence in support of the sbare statomania De not, however, sand any such evidence unless asked to do so by UnmaReceipt of this ferme to net ordinarily acknowledged but your application will be carefully azomined and Uncace will, if need bo, got inta touch with you.Applications for amployment are not normally retained by Unuce for more thse tue pren after receipt.Η pourres de demande de Aureis despois justicies1000 déclarations concelous Ces peces ne derront Etre se que la demande expresse Sca#ste 100eption de ce formu'aire edmine estones, le ces cheant. I'Uncse se mettre en rabuerEn regte gemeeste ne conserve pas les demandes Complar Blus de due as après rece