INSET REY: 1 Da epider te prevent ete! co eehates stun of yume ap fation, avemer every questi early and completely, Ty Snte oe gentin INK. Ine vibe United States Cnal Service rt empeduity sad etaminatyr FER OtiCn read Che enn etn ft vine are Specie fer me ATT SC ee en NAME CF LAMMURATION Ge olen be PSIG APTLIFD DOR DOP NONST GT Tentoned an osanina announcement) POP an Saas “CATION FOR FEDERAL EMPLOY CEATRAL THE tewmENCE Agency fg ON Elicaticn, the fever cand eegarhing distwrei/icm oft an UNWRITTEN enaninarce. . ii spite han € Shamu emient. fie eure fer ey. me owe t. | Motify the office with which atlerae OO NOT WRITE IN THiS BLOCK For Use of Clef Sergizg Commission Only o aa WAT BtaL ERTLPLO ReGistta FL cette eines wee ee Ld areca, ~ g PPACE OF PURE ele a 4. OATE GF Tid demic on ra (J SUBMITTIO e : : Fe al i! SON apne RETURNED be 6 LS AIM 0E fs NSDaT ity AV? inthe of iaaly . . ‘ iM < . APPROVED: CLE Felinert of VEDA 18) CITY OR ASST OFFice (enchuding postal zone} aNd STATE Bere ne PRITUR. aUGs EXUr RATING OF TION re tee : ir meGuere 3 + LEGAL UM VUTISG PESIDEROE (States; SBD TASTE Powisae . wenn ascewnenaee weacnceuet Ponrs fo Lug POINTS fw 5 ren; pO cea a| hasonchuseatts emmnetmeed Or 10 voi? hd * ot erage oye emndemend (eee ttm eteseee Se ee 5 9 Gate OF BIRTH Gmonth, fay, yeas) i} 0 MARPIED . wire 3| Aecerbar 1 Tete TT TTS teens oe witow FH | tf PACE OF BIRTH Coley and Seater ai boon outside U.S. nam O Se Coy oes Le a Pe - er are Gerng 2° {8} WEIGHT, cette teeeeeeee teen e Ll ne a TIGA ED fj : 0 FEMALE tom FtrT ee INCHES 2 16) POUNDS aon te eT ee rr eee reer aaa ‘ encarta Poste ate a cee nene aces ores one i 44, ar AYE vou pitn BSLEN EMPLOYED BY THE FELLA GOVERNMENT? QO YES 40) IF £5, GIVE LAST GRADE AND GATE OF Las? Crance EN GRADE “03. ae wat ss Ing Lowes ENTRANCE SALARY 7OU su RCCEPED 6.2 tf PER VLAN, ; ; You will not be considered for ANY pusitwn with # lowor enirance . Salary. iB) CHECK FP YOU WILL ACCEPT SHORT-Tinw APPOINTMENT |f OFFERED, FOR: 099 9 ONT - J1G § Moores & TO It MONTHS NOTE. Acceptance or rofusat af a temoorary short-taren appoinemant will not aflect your opportunity (o obtem # MrabaGional appuint mont. “GD IP Yes ALP, WILLING TO FRAVEL, SPECIFY: : OLE ASIONALLY FREQUENTLY : Cj CONSTANTLY 6. ExPERItNTE ft ig important for you to furmash all information requested fe in suficsenst detail to enable the Creat ca eUCd Coramiwion and the eppvinting terra af agencies to @ive you fui cs in determining your Quahficatiena Use a separate Block for each gent wo: Stat with your prevent gat) gested work, beck, explaining clearly the principal tasks which You performed in each portion, account Eaperionce gained mere than 1S years age whi is nur pertinent to the werk for which you ase epplying may be aumMmManze? in cot of more of the blocks. Bf your duties thanged materially while working for the same employer, wee B separaic biwk te dencribe each Position. You muy include any vertinent t Qe in PRESENT POSITION iMTIALS AND DATE Dd CMBLE BF. eens wits ACCEPT APPOUMTMENT, IF OFFERED: (2 sn ws: ‘ihe Tow, bc Ld ANVANERE IN THE UNITED STATES CD arcs TRE UKITEO STATES (19 925 DHL atcEPT APPOINTMENT 14 CERTAIN LOCATION ongy, Give ACCEPTABLE LOCATE, gies iment ~ ~ hgiows, rire, weifere, ex organisstional activity which you have Pecformed, either with ce wrkbout campensatvon, showing the number of hours per wcek end weree toe yoer in which you were *Tigsged [sy euch. activity, Biliary eapericnee stort be deeenbed un the epacea belerw in its PYoLer sequence, : (a) Uf yes were veg employed in any position under @ name different from hone eg iieds uf unemployment. that shen uo Item § of this application, give uader “Description ot your work" for, care praition, the Bame used. (8) If gear Leve never been employed of are Sow unemployed, ladlcate € fact in the epace provided below for “Present Position,” ne nn DATES OF EMPLEO FMELNT Gmonth, year) ‘| CRCT THLE OF YouR Patent Pasa | CLASSIICATION GRADE GFT SAAT OW CARNINGS: . i j in Faderal Service) STARTING, 3 _ PER FROM: TO PRESENT Tree tucant, : PRESENT, 5 Pra a So wn i PLACE OF LMALOIMENT (city and State) MAME AND THLE (® IweGSiate SUPERIISOR ren MAMEARD ALORESS OF FMPLOVER (Aran, ordanization, of parson, & Paderal, fame departinent, bureau ot entablhshment, and chvisiony ‘ NUMBER AND Kind OF EMMLOVLES SUPERVISED BY VOU jen oreviete : Pope sd elgewharea REASON FOR LANG TO CHANGE EMPLOYMENT frau the fh ee SE OW CROMRT gn tt ee eee re, RIND OF ©4002 ae CRGARIZATION (9, &.. wholesale giik, Meurance agency, . ’ anulasiere of locks, etc.) f
Ny ha > PERSONAL HISTORY STATEMENT Se ; meen et et Instructions: 1, Answer all questions completely, Uf question ja net applicabis write ONS” Write “unknown” only if you do not know th ee Sand eannat ohcala the anaaver from Perponal recomls, Use the blank pages at the emf of this farm extra eanails on any question or questions for which you do nol Have sulMieiani 2. Type, print, or writy carefully; iHegible er incornplvte forms wee uot recesse consid. eration. ‘ . HAVE YOU READ AND DU YOU UNDE RST AND THE INSTRUCTIONS ee eee renner erence . . ' FOP SEL AAP PE MSTA a eee eee, sea, bP Es Seu. t. PERSONAL BACKGROUND — e LL AGUS. A. FULL NAME Mr. . LEE. hfoaant WV vee Wes PEA. we RIK dn line Noa "tred i Last ~ it Re hee Buse DE - SG SF Initints) PRESENT ADDRESS . af 700.- Que. SrA LA 5 SM ike Ton! 2 4.4... ath, pees WuTihOP § oot Bie ESS 276 Goemour Avs,  Garvevraa Mass LA oe F4 si, pied Nurnber) wg (State) immer PERMANENT ADDRE B, i] NICKNAME oo. seseareeon- WHAT OTHER NAMES HAVE YOU USED ee . i were UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USk iy THESE : ‘ HOW LONG? se IFA LEGAL CHANGE, GIVE PARTICULARS sree te nee tenner cre 3 7 eee ap es re te : €. DATE OF BIRTH coeveeeeveteevtesecee es PLACH OF BIRTH ene en cee eevee sesnneeeveceuens conn nerge pte ces neeaee ee ‘ ; iCiegy (Serer CEompaey 3 : D. PRESENT CITIZENSHIP _. sreverensmeee HY BERTH? oo ee eee BY MARRIAGE? we vere nantes ene 3 . Ulan ry) So . ot WY NATURALIZATION CERTIFICATE NO, preteen EEEU ED oe BY coe eee . : ; . aMates tlanwres } t éCityy State) . . (leary | HAVE YOU HAD A PREVIOUS NATIONALITY? ott rere ree nas nea ernie ees ee ee parce i¥as ay Ro) . (Sensnery HELD BETWEEN WHET DATES? TO nemo: ANW OTE NATIONALITY? idowuvys A GIVE PARTICULARS _.. J HAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIP? oo GIVE PARTICULARS i) Meee Po AS 38-1 See 1958