14-00000 sghe it SECRET (Then Felted bay QUALIFICATIONS UPDATE | ‘ON PRINT, A vom COMPELETIN “READ INSTRECTIO Now that pour qualifications are a matter of computer record, hey mat he periodically updated. This is done auto- moaticalty for much tformation: however, soute must be obtained directly from wou. This forsmis for that DUT pose, Section @ must be completed tn all. ¢ 3.0 You need provide ather information only Wf there have heen changes since wen submiied your Form d44j, “guanifications Supplemen? ta the Persunal History Statement.” of a previous update form, ffoyou are in doubt urhether infarmation has been proviausly submitted, enter it in the apprupriate section, The signed and dated form should be relurned through administrating channels ty fhe File Koons, Office uf Personnel, Room SEs} Headquarters, whether tiformation ts aided of not. : . Additionally, @ qualtfleations update may take place at any tone there ts information ti be added or changed simply by completing and returning an upilate form on your inittatine, > LIGUE COLORED INKS a og MTC aap POSITION OATA ™ ~~ VaTt OF faiRyes bo ra/ay723, eee reer in MAME Chael-Pdsat.widdle) wEGRES ’ MP, iba, an, 9NG198 “ECTION Gi ° “FrYCATEO rm HIGH “CHOOL ADPOLGS CCity. State Cuuntey} a neem, PFaes a feocty (Pram-Jo) neanuarr - Hi 1 oe eee renee Neate meena ane 7 VEAL AT Tinned } BEE vi An : TR Pipe e Oy RECO EYED | fre we nanan eo wb ee Lae ee teen netstat, Last MiGs seHrooL artonnen HAMwr anh LOCATION OF COLLERE Of Gwsvensify | : a nan i eee i i HP OA GHROUATE ULenEE Mag AFEN BOR AbOY fotois AnD ROLF FLY DESCRIAL tts COMTENT, PHICH CEGULeES Tutt sstunm OF A BHITVES Terqes, suescary feet THPLE OF Poer Remarmmemrarewnet Santen oe Ram rear ee tn ep ae ee ante eg pee te rene ee eee een Te ee eee a eres he ee we Leg eet = ~ hate. TRADE, COMMERCHA #20 SPECI MIZEO SCHOOLS HAUL AMD ABDNRIS4 gp 3OHOOL TSR ae cena eran arte ae ent tenon ene pa en ee en eee ene OM- AGENCY EDUCATION Gé TA OCA TED heave NAME AND apoRrre FALESAP EOS Section HN oe “status fed, Widaued Separated Divagre corer Po Fel sin? sratud (Single. dar 2 wae yr SPOUSE {Vabren) (Lear) (fiers 4. PLACE OF Ofare (City. ftare Country) 3. GAPE OF BIRT Ae ee tee nen ae pope ee Tor Rm ene 0 et ae ene en en i eee nae cers eran a eee 4. PRESENT FuPLOYER i UP ARE ON ONCMUF ACOY wera tne D. CARES EM Sede &. ForMin CePeziuse COUNTUY LT ES} HAN SPOUSE CEvL Eb grep pd a nee DEPENDENT CHILOREN AMO DEPEnGiaTS TH RELATION Gere GATE au Bian bane ats tee mat aes SECRET DP elton ———- lars) ie
SECRET eehen MEP b at pr) GEOGRAPHIC ARCA AGCHL EDGE Anu FORTIGH TRAVEL SECTION ¥ etn ernnnneteen  s on on . [eveau ener AC QUEUE RY NAME OF WEGTON , TyPE OF SPEC PALE? EO sates oF THAved, pare A PLACE - Natces nonce ng epee ne OR COUNTY BN DRL PGE oe SE SEBENCT of stuny peaved aruoe | aaetume a Se — Rapublte of “| Secur’ ty forces and | i SeeTion WE ey GA SIEWHOGRAPHIC 5 SKILLS TaTOR TAD APPROPRIATE Oth “SECTION. vil “pRovie ENP OUMATION UN HUDRILS, SPONPS, LICENSES t. TYPING TUPI aie tannery) 3. INET ATE Ba PMAND S SYS a : ; . : : orn | CJ serce a SHER pa PhS _E] stesviere (ls SPEC LEY intense cats SPECHAL QUALIFICATIONS: PoOBLISaE " MATE HPAL S OH UEWEELS rrr YOU MAY TAYE FAVENTEO 1. HAR YOUR Decent ine. VUNWVECH CLAGHEFICATION Chahain? Cite | WEAG ON MILITARY RES ¥ AL GUARD “STATUS CHEE MreeAvE OF AUARD ORGANI: [7] aumy [l] vanine comps [7] codst cuaan [TZ] MATHONAL GuaRD ZATION TO wie Vou PLUONG C) paver lata ronce Je Cl AL NATIONAL GUARD fac ore ened tence wen ne een mn a anata aie anata FE RPIGATION BATE OF CURRENE OnU1GA TION 7 PAPE OF APPOINTMENT IN CURRTOAL RAR a Te a Jer ten 4. EuNCK CumeeNT wes SURVE CATEGORY Cc MEAG MEST RVE ‘| st Cine tives CUGHTT TO ANICH ASSIGNED OR ATTALNED 3. MILITARY MOWILE ZATION ASS we Civilian) ; “MILITARY SCHOOLS COMPLETED CRetended tetive. Reaorve uty, oF STUDY O8 STECTARLLZATHON | DATE COMPLETED 7 ET es ¥ yy ae ene eterna me wR oeeenanrernan for 4 Lil masioeat . | : satecrs @Ponause ect ete ene eeecere ven ene meer ceeneen en pane aree nme renee nee ere ate ne nee mene ee mewn then tye me Steneme Bet Tn meme wae orrenmenae of senrwcmrmnaeng erencmmmmaran, ~ ee . SECTION UX PROFESSIONAL SOCreTi€s AND OTHER | ORGANI ZAI tons SeHOOL AND ADORE $8 OF OF merry) ROWER te ADORESS CNusher Sereet City, State, Count ry} NAwWI ANT CRAPTFA SECTICH X sae ——— “SIGNATURE OF wrtesee as rs G Apt (7 LO | ee HEL. te sien SECRET .