whi, we due pe fou ety SECRET - ) Security Information ‘ Name: Middle TO: ANC. f. A. Personnel FROM: ' Personnel Director SUBJECT: PERSONNEL QUALIFICATION QUESTIONNAIRE ‘is also expected that the new i. The Agency is currently revising the system for machine coding employee qualifications, - thereby permitting more complete, and accurate + data on all pe rsonnel, The new system will aid in implementing Agency policies on promotion from within by facilitating the selection of personnel with desired education and experience for vacancies which may occur. [t system will provide readily accessible statistics for planning and munagement purposes. _ 2. The attached questionnaire is designed to cover adequately those factors in which the Agency is interested. Although the information is, in a large meanuce, already retlected in previous forms submitted by you, it is felt that your time within the organization may enable you to emphasize those qualifications pertinent to its needs. The questionnaire also serves to bring your education and qualifications record up to date, 3, Your cooperation is requested in completing the questionnaire as thoroughly and accurately as possible and returning it to your Adminiatrative Officer within the time allotted. eqn yuk qe se, gyi SECRET Security Information fardce Ppa oO, mar gpag 227888
14-00000 SECRET Securite Infociration PERSONNEL QUA LIFICATION Qu ESTIONHAIRE I. Serial No. [ 2, MAE: (last) (tiest) (middie) {no entry) 3. Office - SORT A inale (1) Martial Status s fernale (2) Nr. Dependents a 4. Acquired By: (i) x Hirth (2 Marriage (4) Other(apecity) citizenship ncquired, if not by birth eeepc (CTA Entry Date: 73 March 63 izens ~~ Other Year US, SEC. I, EDUCATION I. Extent: (circle one) CED —— I. Less than high school 7 feo years college, or less 2. High schoo} traduate 5. Over two years, 3. Trade, Business or Commercial school Nraduate en Naturalization 8, Masters degree. no degree 9. Doctors degree 6. Bachelor deyree ; 7. Post-praduate study {rninimum 8 sem, hre,) 2 College or Univernity Study: (Name and location o Dates att'd] ¥rs Compl Deyree Recd College or University | MajortMinor Fram [To_ Day jNight [Tithe Date enna aera wrmmre af a : . rade, Comimercia es and Opecialize Wtendance Dates Sem firs raining: School Military or Intelligence schools such as inte! Staff, ete.) Attendance: Dates School From To Tot.mo's ounher Intelligence Can Lemur by, .  .f Apre$2) Apres? > y matructor Guidance Caurad senso, Training (fall time duty #5 a student in specialized ligence, communic ations, ordnance disposal, command & Study or Specialization : Instructor, CIC School Saeed ECF!
Se SECRET Security Ldformatio. SEC. UL. WORK EXPERIENCE ; 1, CIA Experience: State the specific nature of dutics performed with CLA and CiG, starting with your present position, Take position titles from your of- Please do not request ficial personnel papers, if you have personal copies. your Official Personnel Folder. Include yeoyraphic area and subject matter dealt with, if applicable. Position Title is your classification title such as Geographer, Intelligence Officer, cte, Duty Title indicates your oryanization position such as - Section Chief, Branch Chief, Administrative Assistant, ete, and is to be filled in only if different to the Position Tithe, Approximate dates (month and-year) are sufficient. Use a continuation sheet, if necessary, te adequately describe your duties. - Froma3 yan FP Tot,mos. Description of Duties: rade GS. 9 Salary Senn Office —y 155 : : [— = commas Duty Title: Technical BroJ nha Offioer p otati vee CO From To Tot. mos. Description of Duties; tenn - ao’ rade — Salary — renner Office Position Title: Duty Title: | a Duty Station, if overseas: From To . Tot. mos, rade Sala ry Office Position Title: Duty — Title: From To Tot. mos. Grade Salary Office Position Title: Duty Title; ‘SECRET Security Information