[104-10291-10002.pdf — page 230]
# SECRETSECTION VGEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL| NAME OF REGION OR COUNTRY | TYPE OF SPECIALIZED KNOWLEDGE | DATES OF TRAVEL OR RESIDENCE | DATE & PLACE OF STUDY | KNOWLEDGE ACQUIRED BY CHECK (X) |        |       |                || ------------------------- | ----------------------------- | ---------------------------- | --------------------- | ------------------------------- | ------ | ----- | -------------- ||                           |                               |                              |                       | RESI- DENCE                     | TRAVEL | STUDY | ADDITION- ALLY ||                           |                               |                              |                       |                                 |        |       |                ||                           |                               |                              |                       |                                 |        |       |                ||                           |                               |                              |                       |                                 |        |       |                ||                           |                               | FRIE 10-24 AUG 72            |                       |                                 |        |       |                |SECTION VITYPING AND STENOGRAPHIC SKILLS1. TYPING (WPM) 2. SHORTHAND (WPM) 3. INDICATE SHORTHAND SYSTEM USED - CHECK (X) APPROPRIATE ITEM[] GREGG  [] SPEEDRITING  [] STENOTYPE  [] OTHER SPECIFY:SECTION VIISPECIAL QUALIFICATIONSPROVIDE INFORMATION ON HOBBIES, SPORTS, LICENSES, PUBLISHED MATERIALS OR DEVICES WHICH YOU MAY HAVE INVENTED.SECTION VIIIMILITARY SERVICECURRENT DRAFT STATUS1. HAD YOUR SELECTIVE SERVICE CLASSIFICATION CHANGED?[] YES  [] NO  2. NEW CLASSIFICATION3. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS  4. IF DEFERRED, GIVE REASONMILITARY RESERVE, NATIONAL GUARD STATUSCHECK RESERVE OR GUARD ORGANIZATION TO WHICH YOU BELONG[] ARMY  [] MARINE CORPS  [] COAST GUARD  [] NATIONAL GUARD[] NAVY  [] AIR FORCE  [] AIR NATIONAL GUARD1. CURRENT RANK, GRADE OR RATE 2. DATE OF APPOINTMENT IN CURRENT RANK 3. EXPIRATION DATE OF CURRENT OBLIGATION4. CHECK CURRENT RESERVE CATEGORY [] READY RESERVE [] STANDBY (Active) [] STANDBY (Inactive) [] RETIRED [] DISCHARGED5. MILITARY MOBILIZATION ASSIGNMENT 6. RESERVE UNIT TO WHICH ASSIGNED OR ATTACHEDMILITARY SCHOOLS COMPLETED (Extended Active, Reserve Duty, or as Civilian)| NAME AND ADDRESS OF SCHOOL | STUDY OR SPECIALIZATION | DATE COMPLETED     || -------------------------- | ----------------------- | ------------------ ||                            |                         | RESIDENT           ||                            |                         | AGENCY - SPONSORED |SECTION IXPROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS| NAME AND CHAPTER | ADDRESS (Number, Street, City, State, Country) | DATE OF MEMBERSHIP |     || ---------------- | ---------------------------------------------- | ------------------ | --- ||                  |                                                | FROM               | TO  ||                  |                                                |                    |     ||                  |                                                |                    |     |SECTION XREMARKSDATE 7 APR 1977SIGNATURE OF EMPLOYEE![Signature of employee]SECRET