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SECTION I - IDENTIFICATION DATA SECTION II - CLASSIFICATION AND ASSIGNMENT DATA (Conltnu6d)

1. NAME 2. S.S.N. 6. MILITARY OCCUPATIONAL SPECIALTIES [ ]CONT

WILLIAM:) KfNNEH-l VE'RNON ~

MOSC TITLE DATE

SECTION II - CLASSIFICATION AND ASSIGNMENT DATA

3 ) MOS EVALUATION SCORES [ ]CONT

MOSC YR& MO SCORE YR& MO SCORE YR & MO SCORE

4. ASSIGNMENT CONSIDERATIONS l JCONT

·1l.(m~l~ ('.t-f("J17 ~ (-Jf.?.{ol\I-ZJ()·~~ir. G-3 W?U "l=<::'YJlIS

7J AVIATION ASI & GUNNERY QUALIFICATION l JCONT B )APTlTUDE AREA SCORES r 1CONT

AIRCRAFT INSTR PILOT GUNNERY SYSTEM AREA SCORE AREA SCORE

Frw ANI FrN RIW TNG INSTR GT 110

G "1 l;~~3

EL 1,20

Cl 116

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5, OVERSEA SERVICE r CaNT DEPN 9. AWARDS, DECORATIONS & CAMPAIGNS [ lCONT CO L~4

FROM THRU AREA AND COUNTRY MO TYPE NTC ARR as I~~!..-tl~~,/t"'" ~

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PLACE rt:')1" "'7i

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10. OTHER TESTS )CONT

TEST DATE SCORE

MOB· X

OCT

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11,

AMERICAN BOARD CERTIFICATION

& LICENSES OR CERTiFICATES HELD DCONT

12. LANGUAGE PROFICIENCY

OA FORM 330 DATE

SUBMITIED

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SECTION II - CLASSIFICATION AND ASSIGNMENT DATA (Contlnuod) SECTION III - SERVICE, TRAINING AND OTHER DATES

If131 PILOT RATINGS 18. APPOINTMENTS AND REDUCTIONS I jCONT '19:SPE,PI\LlZED TRAININGf 1CONT

ORIGINAL 1 DATE 1 CURRENT 1 DATE EFFECTIVE DATE OF SUBJECT ..•. DATE

1 1 1

GRADE CO~,1P 8A,:= EUG.!RANK ATP 21·114 (aCT) >O(J7/7

! L14J FLYING STATUS r CONT PVl iXrx)7/~ Geneva-Hague 970702(, tJrL- <? iI ()II~ Conventions

W ~(' c:,( )( O/fb Military Justice ;.;.'N,') f(. .

INSTRUMENT CERTIFICATION lCSI)(1

;':'-UYI15 Benefits of

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Honorable

If151 INTERNSHIPS, RESIDENCIES AND FELLOWSHIPS r leONT Discharge

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HOSPITAL TYPE OR SERVICE MONTHS YEAR STD Of car ?:/7{)1/~

RACE REL-I. Y?D?~

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IL16J HOSPITALfTEACHING APPOINTMENTS AND PRIVATE PRACTICE [ ] CONT .@ BASIC ENLISTED SERVICE \>;t '7F~'- FROM THRU INSTITUTION/LOCATION TYPE DURAT DATE (BESD) (, ) I •. ,1

,(21) TIME LOST Sec. 972, Tit/e 10, USe) [ JCONT

FROM THRU DAYS REASON

17. CIVILIAN EDUCATION AND MILITARY SCHOOLS l

CONT SECTION IV - PERSONAL AND FAMILY DATA

SCHOOL MAJORtCOURSE/MOSC DURAT

,,---,.

COMP YEAR 22. PHYSICAL STATUS 23. PLACE OF BIRTH AND CITIZENSHIP

\Jfl2 r rl1JSOnJ J-\~, (;"'Ff\.) LJ YI='\. f)l~ HEIGHT 1 WEIGHT 1 GLASSES SELF ,I {'- K a=.

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DATE OF EXAM ,

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·~r".f..)" _,_ CITIZENSHIP OF SPOUSE

24. NUMBER OF DEPENDENTS 25. HOME OF RECORD/ADDRESS

ADULT CHILDREN

26. CIVILIAN OCCUPATION

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DOT CODE CRITICAL OCCUPATION INO. MONTHS IMose

DYES DNO

EMPLOYED

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SECTION VII - CURRENT AND PREVIOUS ASSIGNMENTS

35. RECORD OF ASSIGNMENTS [ ]CCNT

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EFFECTIVE ORGANIZATION AND STATION T'lPE

DATE

DUTY MOSC PRINCIPAL DUTY OR OVERSEA COUNTRY REPORT BP EP

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