[104-10224-10001.pdf — page 118]
# SECRETQUALIFICATIONS UPDATEREAD INSTRUCTIONS CAREFULLY BEFORE COMPLETING, TYPE OR PRINT, AVOID USING LIGHT COLORED INKSNow that your qualifications are a matter of computer record, they must be periodically updated. This is done automatically for much information; however, some must be obtained directly from you. This form is for that purpose. Section I must be completed in all cases. You need provide other information only if there have been changes since you submitted your Form 4441, "Qualifications Supplement to the Personal History Statement." or a previous update form. If you are in doubt whether information has been previously submitted, enter it in the appropriate section. The signed and dated form should be returned through administrative channels to the File Room, Office of Personnel. Room 5E-13 Headquarters, whether information is added or not. Additionally, a qualifications update may take place at any time there is information to be added or changed simply by completing and returning an update form on your initiative.## SECTION I BIOGRAPHIC AND POSITION DATA| IMP. SER. NO. | NAME (Last-First-Middle)   | DATE OF BIRTH | SD  | GRADE || ------------- | -------------------------- | ------------- | --- | ----- || 035655        | MAKSYMIEC, Myroslaw Andrew | 30 April 1912 | 9   |       |## SECTION II EDUCATION| LAST HIGH SCHOOL ATTENDED | ADDRESS (City, State, Country) | YEARS ATTENDED (From-To) | GRADUATE   || ------------------------- | ------------------------------ | ------------------------ | ---------- || WASHINGTON                | D.C.                           | *High School*            | Yes ☐ No ☐ |### COLLEGE OR UNIVERSITY STUDY| NAME AND LOCATION OF COLLEGE OR UNIVERSITY | SUBJECT          | YEARS ATTENDED | DEGREE RECEIVED | YEAR RECEIVED | NO. SEM/QTR HRS. (Specify) || ------------------------------------------ | ---------------- | -------------- | --------------- | ------------- | -------------------------- || 1. MONTGOMERY JUNIOR COLLEGE               | Major: *ENGLISH* | FROM-TO:       | 3 *hrs*         |               |                            || 2. AMERICAN UNIVERSITY, DC                 | Major:           | *To Africa*    |                 | 1.8 *hrs*     |                            |IF A GRADUATE DEGREE HAS BEEN NOTED ABOVE WHICH REQUIRED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE OF THE THESIS AND BRIEFLY DESCRIBE ITS CONTENT.### TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS| NAME AND ADDRESS OF SCHOOL | STUDY OR SPECIALIZATION | FROM | TO  | NO. OF MONTHS || -------------------------- | ----------------------- | ---- | --- | ------------- ||                            |                         |      |     |               |### OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE| NAME AND ADDRESS OF SCHOOL | STUDY OR SPECIALIZATION | FROM | TO  | NO. OF MONTHS || -------------------------- | ----------------------- | ---- | --- | ------------- || DEPT OF AGRICULTURE        | *ADVANCE COURSE*        |      |     | 6-415         |## SECTION III MARITAL STATUS1. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, Annulled, Remarried) SPECIFY:| 2. NAME OF SPOUSE | (Last)    | (First) | (Middle) | (Maiden) || ----------------- | --------- | ------- | -------- | -------- ||                   | MAKSYMIEC | Eileen  | E        | Burke    || 3. DATE OF BIRTH | 4. PLACE OF BIRTH (City, State, Country) || ---------------- | ---------------------------------------- || 15 Oct 1941      | WORCHESTER MASS                          || 5. OCCUPATION | 6. PRESENT EMPLOYER || ------------- | ------------------- || HOUSEWIFE     |                     || 7. CITIZENSHIP | 8. FORMER CITIZENSHIP(S) COUNTRY(IES) | 9. DATE U.S. CITIZENSHIP ACQUIRED || -------------- | ------------------------------------- | --------------------------------- || YES            |                                       |                                   |## SECTION IV DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE|                      | NAME | RELATIONSHIP | DATE AND PLACE OF BIRTH | CITIZENSHIP | PERMANENT ADDRESS || -------------------- | ---- | ------------ | ----------------------- | ----------- | ----------------- || 1. ☐ ADD<br>☐ DELETE |      |              |                         |             |                   || 2. ☐ ADD<br>☐ DELETE |      |              |                         |             |                   |