Tofe sey fleet tyes wg ess TD. tM aget See tee pra; at Oya gt bre a fates Eg Boda ey ce Dm ne me memin meee etopeag fra fo fan Dat ah, TER tet Fa OLAS, De. cecenecnrencseenensaees ATLLESEOR ~ | Asteny Or Pr, HARVARD Uarrd, Phares CR LAALID, LVBEN er cecrcccee eosenen eee RAIL TCE yp LASS Scanners PACA ELENA Fa 9 at iP bf fab oF ad Fly 7” rene BEER LIE LY hen BLM CS" OR MO” AMEWLA BT PLECING “a IM PROPER CORUM: Wt PuQPLa, ‘caLgem ‘MDICATE “YEE “HEE OB CRD anger? F PLAting * 2S Var ee OF ware CP YOUR RESET Petco E BIGARLIEG YOuR CURRACT EH GUALIRICaTIONS ¢ . 3 ‘ 2h ARP fons & CITUILS OF OR DD : SIATESI. |, es vee . Jt CUES THE UBETYD STATEG GOVENNUENT EMPLOY 1M A CECH IAM CAPACITY RAY REL GQHIVE OF YOURS (DY BEOAIO CA MARRIAGE: WITS WOH YOU LIVE . * OA RAGE LIVED WEDHAN Piet FAST Le MONT EST 48 Pour anaes ie Vou! ato in fren y tot EACH gach | seletirve (2) fail same, (2) present auddresa: i relotsunahen: “44> Department ar Agency hy wAwh eanplere ond (3) kind att kad Preant SPECIAL INSTRUCTIONS FOR CLAIMING VETERAN’ PREFERENCE “AL Uf you are claiming preference ag a PRACK TIME VETERAN who Sas iren swardet @ compaign badge of presive cibtwn, «ee @ DISANLED VET. ERAN, of es the WIFE OF A DISARLED VRTRRAN, or ar the WIDOW OF A Wak OR CAMPAIGN VETERAN, attach Veteran, Preference Cleura, CSC Feem 14, together with peal & evita therein. . B. Ef you are @ WARTIME VETERAN not cletning disabitity preference, you should NOP submit your diecharge with thie agpheetion. Preference wit be tentatively credieed ta you andif epqunted, yr will be required te gadsrs ‘to the appuinting officer prior ta entry an duty, official evi dence of seyvara~ dium fram active service in the armed ferere of the Uni SS AKL POU SC OFFICIAL OW EMPLOVED OF ANY $ : OR MUNICIPRLED YE | ne of etfs orem f6 your answee 28 IPATIONT ‘or SANIZE TION, WINK AD. AU OH OF GOLEUVENT,, AERO COMMA THOM eA a ARE OU MA O4 WANE YOU ES BSTOTIATION MRE MEST GRO VOCAIES PME OCU THROW OF OUP Ce OR CF AM OUCANIZATIOM ASSOCPATE Br, OF PLHSON'. WICH HAS ADOPTED A TPULIL GY POON Pose COM AO OF ACTS CE FOBLE Os eee TEE CrP ee Be BE PoehaBt RIAA POE Ted COMSAT is aE Ld TD STALES OR GF SLE. ING TO ALTER Tt FOR OF GOVEARVENT OF Det SO.TEU STATES Of URCGH. 7 SUTUNONAL MEANE o. ., S cee Ef your anawer to question 22. 34 08 BY oh aca by pea! state 5 RB. in deer JP the names ol allsuch wrhanimatiess, asvouintions, | EBS 375 a WERE YOU PVER IN THE UNITED STATLS MILITARY 08 WAVAL SEAVICE imoavernenta, §tuivger, or cambunation of peseonaand datee af ; . tnembarahiige ee 6 complete ditaids of your activities DURING TIME CF WAKE oss cess eennenescnernesestonmennatereeranesieanen a fa Pref bs, " ive di = a cherein aed tpeke ame orblane tg pag dese regarding + ABT IS THE WORT “HORORANLL’ OR THE WORD CSA LP ACTORE USED | ’ meee a IN YOUN CISCHARGE OF LT PARATION PAPERS To SOW Toll TTPL OF YOUR ! i SSCHAHGE OF SCPAHATIONP:; 10) WAS SERVICE MU ORME ON A! netiVe Puna. teat Bases, “wits Fu SOLITARY PAT AND ALLOWAN CO, INDICT Eo, 1, PROCE EDGING, GEM NTL Age 30, SINCE YOUR (aT BIRTHOEY, HAGE 1 a re OW SIMMORED FIO COURT AS A LEFT! OR CONVICTED, FIED. OR DVUPRIGG ED SHALOM. OR BASE oF . FO Ue Gee ne re eee notte ee SINFO SLALICN | UATE GF SEPATAIIIN OR SUPARATIONS TRAS 6 IC VIGLA TIONS FOR wastCrs AFIS fend a GF 1S OR LEDS WAS 1 Ce IMPOSE DIT... HS tive ne jeep yg" 3 Bet, Te ‘ if your an 7 “het olf eae! ‘ a taster ftar “tT Baa Nii (sf “none, ins below. "Girma anch coun BY tte dete 2) ihe vane of the Macine Corps, Const Guard, ots. | eating af tlie of separation). } 5 aoe FP pee ; aed, Many, af otter depuvtion uf the foyer nid! he taker JA HAVE YOU EVER ULER DISCHARLLD, OR CONE ED It BESTN, FOR MiZCGR. DUCT OF BEGATISFACTORY SERVICE FROM brit # SVIOME cae Hf yaue anewor ia ‘Yea, give an frees av the name and adidrene of empluyar, date, and reaeur 1s carh case, (4) the poenaliy im case, HH apzasitited. your Anges gor itt 3318) UF YOU SERVED IN PRE UNITED STAVES NELITAN ES OF MA JAL SERVICE H v.RENG PEACE TIME ONS ¥, DID YOU FASTICINATE IM A CAV PAE fe GE ERPEOI 7 | HON AND RECRIVE A CAMPAIGN SALGE OR SLRAICE: HIBOUAE 0... eee i (B) ARE YOU A DISABLED VETERANE, ff ao. and you have nut sted ¥ we disability in shower to | fiem 34, siplain in ftom 39 halow-: (C) ARE YOU A VCTERAN'S WIDOW WHO NAS SOF ALMANMEDP : it! ANE YOU THE WIFE OF A VETPRAN Wd HAS A SERIE CONRICTED | H SIS*SHITY WIECH PICO ALIFE S HOM ROR CIVIL Soe ADI tee aT? . ee A eA E THIS SPACE FOR USE OF APPOINTING OFFICER ONLY as The information contained (n the answcre to Questivg 37 sbove haa been wer- Sa vee ee PRL 32. HAVE YOu FVER BLEN GARRED 89 Tet S fie Stiencr comsission FROM TARO TAATONATICNS C8 ACCEPTION CUUL SU RVICL ARPOINE MELA OS. ff your anuawaer ie “Ves.”' dive dasrae of and raenceons for euch debarment in frem 3%. 33. HAVE YOU AMY PHYSICAL KASDICAF, LILTASE, OR OTHLA DISABILITY WHICH SROQULD BF. FON BOE ATO PR ASSIS FOL Ti ATER, Hyowe answer is Yer,” give curnzlete detaits in mi? so that consideration can be gen to your phyarical firness for the job. BA. DO YOU RFCOIVE AM ANNUITY FROM Te? UTED STATES OR DISTRICT OF COLUMOIA GOVEHAMENT UNDER 267 RETIFA ET ACT OF ANY PERGICN vy OR OFF COMPLETATON FOR MILITARY Gi Be VAL SLRYIGET, 4. 4 df your anewee in Yes." give come tete detaite in diem 39. hed by comparison with the chacharge eevttheate ut ...,..0.0-c00e ad et gy panda To elas Garde Orr a Pe ae ret eres er Seer nee aee eee Attach to inmde Write on each sheet your aame, address, date of birdh, amd eaaininalion title. if moce apace ie required, use paper the ‘same ¢ sige ae this page. of this application. Before signing this application cbeck onack over it to make sure that you have answered ALL questions correctly, 1 CERTIFY that the statements made by me in this epplication dre true, complete, and correct (6 the beat of my knowledge and belief, and are made in good faith. : Folse atatement on this application GRED™ SIGNATURE OF APPLICANT AL : is punishable by Law (U.S. Code, {Sign your aame in INK fone giv: ee, initial of igitiale, and surname}. Ef female, Title 18, Section 80). a mf prese Bliss ot Mrs. and if marcicy our oan given name as “Mire. Mary Lo Doe") . . U.S. GOVERNMENT PRINTS COPE See -O- 89297 16--81066-2