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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)Rife, Rebecca Anne125 South Reynolds St., Apt. J-410Alexandria, Va. 223042. Home phong (including Area Code) 3. Other phone (including Ares Code)370-6755 Friend Judy Sullivan 697-1173Leave messages4. Kind of job you are applying for:Secretarial/Staff Assistant5. 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? Immediately9. 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)11/11/4211. Home StatePennsylvania12. HeightFeet 5 Inches 6 1/213. Are you a United States citizen?Yes No14. Lowest acceptable annual salary    in specific figures$10,50015. Number of dependents. other than self016. Weight12517. Social Security Number192-34-078118. SkillsTyping -75-80- wpm. Shorthand @85-90 wpm.(To be considered for positions involving typing or shorthand, applicants must undergo tests actually administered either by the Placement Office or by the U.S. Civil Service Commission. If the latter is used, attach Notice of Rating datal within the past 12 months.)Office equipment (specify)Computer: Terminal Operator, Programmer, Systems Analyst(State expertise with specific systems, languages, and components.)19. List eligible ratings attained on U.S. Civil Service Commission examinations, titles of examinations and dates of ratings.Have been a G.S. 8 Social Worker. On Mid-Level Register and Clerk-Typist20. Did you graduate from high school, or will you graduate within the next nine months? Yes June 1960 RegisterCourse emphasis: Academic, Business, Other (specify)21. 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, certiticales, and any other pertinent data.Waynesboro Business School, Waynesboro, Pennsylvania - Attended during high school and studied typing and speed-writing.22. A. Name and location (City and State) of colleges or universities attended.| COURSES STUDIED                     | CREDITS COMPLETED | Grade-Point Average on 4.0 Scale | Rank in. Class | Dates Attended | Type of Degree | Year of Degree |      || ----------------------------------- | ----------------- | -------------------------------- | -------------- | -------------- | -------------- | -------------- | ---- || Major                               | Minor             | Semester                         | Quarter        |                |                |                |      || Chatham College, Pgh., Pennsylvania | Psyc/Soc.         |                                  |                | 3.2            | Upper 1/2      | 1960-64        | B.A. || B. Chief undergraduate college subjects           | CREDITS COMPLETED | C. Chief graduate college subjects | CREDITS COMPLETED |         || ------------------------------------------------- | ----------------- | ---------------------------------- | ----------------- | ------- ||                                                   | Semester          | Quarter                            | Semester          | Quarter || Strong liberal arts                               |                   |                                    |                   |         || Many survey courses (including political science) |                   |                                    |                   |         || Psychology/sociology major                        |                   |                                    |                   |         |D. Special achievements and awards. (Provide all scholastic achievements and honors and show participation in extracurricular, civic, community and similar activities, and in professional and scientific societies.).Awarded full college scholarship from Fairchild Aircraft Corporation Hagerstown, Maryland23. Other languages. (Show proficiency in speaking, writing, and reading.)Some French24. Dates of military service, if any.Branch: N.A. 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.)|                                                                                                                                                                                                                                                                                                                        | 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 ofense committed prior to your 21st birthday which was finally adjudicated in in juvenile court or under a Youth Ofender Law.)... |     |     || 26. While in the military service, were you convicted by general court-martial or discharged under other than honorable conditions?...                                                                                                                                                                                 |     |     || 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 affice.)                                                                         |     |     |28. Space for detailed answers. Indicate Item number to which answers apply.| Item No. || -------- ||          ||          ||          ||          ||          ||          ||          |Do Not Write In This BlockTEST RESULTSTYPING: 77 W.P.M. ON A 5 MINUTE TEST81 W.P.M., 4 ERRORS)SHORTHAND: W.P.M. ON A 3 MINUTE TESTOTHER TEST SCORES:VERIFIED BY: DATE: