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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 Cod.   202-547-3049 202-225-2906   ASK FOR MARILYN4. 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 Representa-   tives, 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, applicants    must 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 dated    within 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 ☐ No    HIGHEST GRADE COMPLETED    Course 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, Michigan22. A. Name and location (City and State) of    colleges or universities attended.University of UtahCOURSES STUDIEDMajorhist.Minorphil.CREDITS COMPLETEDSemesterQuarter190Grade PointAverage on4.0 Scale2.7RankinClassDatesAttendedFrom62To69Type ofDegreeBSYear ofDegree'69B. Chief undergraduate college subjectsCREDITS COMPLETEDSemesterQuarterC. Chief graduate college subjectsCREDITS COMPLETEDSemesterQuarterD. 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 achieve-ment 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.:From:To:Answer the following questions. (If you answer "Yes" to any of these questions, give all pertinent details in Item 28.).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.).YES NOX26. While in the military service, were you convicted by general court-martial or discharged under other than honorable conditions?.    X27. 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.)X28. Space for detailed answers. Indicate Item number to which answers apply.Do Not Write In This BlockItem No.27TEST RESULTSRettested 9-27-761Nancy L. LarsonTYPING:71 W.P.M. ON A 5 MINUTE TEST2sister78 W.P.M., 7 ERRORS)3Office of GuamFederal BuildingSan Francisco, CASHORTHAND:80 W.P.M. ON A 3 MINUTE TEST5OTHER TESTSCORES:VERIFIED BY: APW 104 DATE: 9/3/74NW 88326 ATTIDESS:Docld:32239471 Page 21JOINT COMMITTEE ON CONGRESSIONAL OPERATIONSOFFICE OF PLACEMENT AND OFFICE MANAGEMENTWASHINGTON, D.C. 20515