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# Congress of the United States## Employment Information Form1. Name (Last, First, Middle)Mr. ☑ Miss Mrs.and Address (Number, Street, City, State, and ZIP Code)Larson, Billie Gay514 Sixth St. SE Apt. AWashington, D. C. 200032. Home phone (including Area Code) 3. Other phone (including Area Code)202-547-3049 202-225-2906ASK FOR MARTYN4. Kind of job you are applying for:secretarial, research, clerk5. Term of Employment: ☑ Full Time ☐ Summer6. Will you accept temporary employment? ☑ Yes ☐ No7. Will you accept part-time employment? ☐ Yes ☑ No8. When will you be available? 9-20-769. Are you presently employed by the U.S. Senate, the U.S. House of Representatives, or other office of the Congress? ☐ Yes ☑ No10. Birth date (Month, Day, Year)    5-19-4411. Home State    Utah12. Height    5 Feet 6 Inches13. Are you a United States citizen?    ☑ Yes ☐ No18. Skills☑ Typing 75 wpm.(To be considered for positions involving typing or shorthand, applicantsmust undergo tests administered either by the Placement Office or by the U.S.Civil Service Commission. If the latter is used, attach Notice of Rating datedwithin the past 12 months.)☐ Office equipment (specify)☐ Computer: ☐ Terminal Operator, ☐ Programmer, ☐ Systems Analyst(State expertise with specific systems, languages, and components.)14. Lowest acceptable annual salary    in specific figures    $ 13,00015. Number of dependents other    than self 016. Weight    11017. Social Security Number    529-60-6414☑ Shorthand 80 wpm.19. List eligible ratings attained on U.S. Civil Service Commission examinations, titles of examinations and dates of ratings.196420. Did you graduate from high school, or will you graduate within the next nine months? ☑ Yes 5/62 ☐ NoHIGHEST GRADE COMPLETEDCourse emphasis: ☑ Academic, ☐ Business, ☐ Other (specify) debate, journalism, drama21. Training schools attended (for example, business, vocational, armed forces, or trade). Give for each the name and location of school, dates attended, subjects    studied, number of classroom hours of instruction per week, certificates, and any other pertinent data.Supervisory Development SeminarForemost Insurance Company (one week seminar, spring '75)Grand Rapids, Michigan|                                                                                  | COURSES STUDIED | CREDITS COMPLETED | Grade-Point Average on 4.0 Scale | Rank in Class | Dates Attended From | To  | Type of Degree | Year of Degree || -------------------------------------------------------------------------------- | --------------- | ----------------- | -------------------------------- | ------------- | ------------------- | --- | -------------- | -------------- || 22. A. Name and 'location (City and State) of colleges or universities attended. | Major Minor     | Semester Quarter  |                                  |               |                     |     |                |                || University of Utah                                                               | hist. phil.     |                   | 2.7                              |               | 62                  | 69  | BS             | '69            ||                                         | CREDITS COMPLETED |                                    | CREDITS COMPLETED || --------------------------------------- | ----------------- | ---------------------------------- | ----------------- || B. Chief undergraduate college subjects | Semester Quarter  | C. Chief graduate college subjects | Semester Quarter  |D. Special achievements and awards. (Provide all scholastic achievements and honors and show participation in extracurricular, civic, community and similaractivities, and in professional and scientific societies.)Awarded scholarship to University of Utah based on academic achievement and extracurricular activities. Current membership in SierraClub and Common Cause.23. Other languages. (Show proficiency in speaking, writing, and reading.)    read some French and Spanish24. Dates of military service, if any.Branch: NA Rank: Serial No.:Answer the following questions. (If you answer "Yes" to any of these questions, give all pertinent details in Item 28.).|                                                                                                                                                                                                                                                                                                                     | YES | NO  || ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- | --- || 25. Have you been convicted of any offense against the law or forfeited collateral or are you now under charges for any offense against the law? (Omit all traffic violations and any offense committed prior to your 21st birthday which was finally adjudicated in juvenile court or under a Youth Offender Law.) |     | X   || 26. While in the military service, were you convicted by general court-martial or discharged under other than honorable conditions?                                                                                                                                                                                 |     | X   || 27. Does the U.S. Government employ in a civilian capacity any relative of yours (by blood or marriage)? (If your answer is "Yes," list in Item 28 for each relative: [1] full name; [2] relationship; and [3] department, agency, or office.)                                                                      |     | X   |28. Space for detailed answers. Indicate Item number to which answers apply.| Item No. | 27                || -------- | ----------------- || 1        | Nancy L. Larson   || 2        | sister            || 3        | Office of Guam    ||          | Federal Building  ||          | San Francisco, CA |Retested 9-27-76Do Not Write In This BlockTEST RESULTSTYPING: 71 W.P.M. ON A 5 MINUTE TEST78 W.P.M., 7 ERRORS)SHORTHAND: 80 W.P.M. ON A 3 MINUTE TESTOTHER TEST SCORES:VERIFIED BY: APW DATE: 9/13/7/JOINT COMMITTEE ON CONGRESSIONAL OPERATIONSOFFICE OF PLACEMENT AND OFFICE MANAGEMENTWASHINGTON, D.C. 20515NW 88326MAILING ADDRESS:DocId:32239471 Page 23