[104-10224-10001.pdf — page 146]
SECRET# SECTION VII1. ARE YOU REGISTERED FOR THE DRAFT?☐ YES   ☐ NOCURRENT DRAFT STATUS2. SELECTIVE SERVICE CLASSIFICATION3. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS4. IF DEFERRED, GIVE REASONMILITARY SERVICE RECORD *Active Duty Only*1. MILITARY ORGANIZATION (Army, Navy, etc. specify)2. BRANCH OF CORPS3. DATES OF SERVICE (extended active duty)FROM:TO:4. STATUS (Regular, Reserve, etc. specify)5. RANK, GRADE OR RATE (at separation if past service)6. SERIAL SERVICE OR FILE NUMBER7. CHECK TYPE OF SEPARATION☐ HONORABLE DISCHARGE☐ RELEASE TO INACTIVE DUTY☐ RETIREMENT FOR AGE☐ REENLISTMENT FOR SERVICE☐ RETIREMENT FOR COMBAT DISABILITY☐ RETIREMENT FOR PHYSICAL DISABILITY☐ UNDUE HARDSHIPS☐ OTHER (Specify)8. BRIEF DESCRIPTION OF MILITARY DUTIES (record the duties and skills which best describe your work or function in the military service)*NONE*MILITARY RESERVE, NATIONAL GUARD STATUSCHECK RESERVE OR GUARD ORGANIZATION TO WHICH YOU BELONG☐ ARMY☐ NAVY☐ MARINE CORPS☐ AIR FORCE☐ COAST GUARD☐ NATIONAL GUARD☐ AIR NATIONAL GUARD1. CURRENT RANK, GRADE OR RATE2. DATE OF APPOINTMENT IN CURRENT RANK3. EXPIRATION DATE OF CURRENT RESERVE OBLIGATION4. CHECK CURRENT RESERVE CATEGORY☐ READY RESERVE☐ STANDBY (Active)☐ STANDBY (Inactive)☐ RETIRED☐ DISCHARGED5. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES (record the duties and skills which best describe your work or function in the military service)*NONE*6. IF YOU ARE CURRENTLY ASSIGNED TO A RESERVE OR NATIONAL GUARD TRAINING UNIT, IDENTIFY THE UNIT AND ITS ADDRESS.| MILITARY SCHOOLS COMPLETED (*Active Duty, Reserve Status or as Civilian*) |                         |                  |     || ------------------------------------------------------------------------- | ----------------------- | ---------------- | --- || NAME AND ADDRESS OF SCHOOL                                                | STUDY OF SPECIALIZATION | DATE COMPLETED   |     || 1.                                                                        |                         | RESIDENT         |     || 2.                                                                        |                         | CORRESPONDENCE   |     || 3.                                                                        |                         | AGENCY SPONSORED |     || 4.                                                                        | *NONE*                  | RESIDENT         |     || 5.                                                                        |                         | CORRESPONDENCE   |     ||                                                                           |                         | AGENCY SPONSORED |     ||                                                                           |                         | RESIDENT         |     ||                                                                           |                         | CORRESPONDENCE   |     ||                                                                           |                         | AGENCY SPONSORED |     ||                                                                           |                         | RESIDENT         |     ||                                                                           |                         | CORRESPONDENCE   |     ||                                                                           |                         | AGENCY SPONSORED |     |SECRET- 4 -