Document zQ60ROeRJkrz68yvKLjojypGa

SPECIAL INFORMATION CYWI 4-001368 APPLICATION FOR EMPLOYMENT DO NOT WRITE IN THIS SPACE Dept.____ ForemanJob TitleRate_____ Towel___ XGJ_____ Storted__ PPrriinntt Nome. Address Phon Date of Birth C.Cr aihT_ _____ _________ / --/ u,- snc'.r io/'. St. & No. !*City Soc. Sec. No._ 21 Married [j Single Q Widowed >! ' 1 W ^ Dote--_h_ Initioi 7t L_| Divorced U. S. Citizen? 1/ 7 ^ Height-(p. .7-_______ Weight / LW________Are You Physically Handicapped? AJ 0______How?. Any record of convictions?_____A^. t_For what offense? 1 Have you friends or relatives in our employ? OWho? In an emergency, whom shall we notify?-. tVl/lcior.-& Cazgiir____3 a/V ^ Nan* 1 Addrra Phone .How related? A.' >' C~ Grade SchoolHigh School__ Other_________ Vl i( EDUCATION vO o EXPERIENCE EMPLOYER. I3_P TTrV C Address- /6 3v_. S fts<4'AJr' From frlntnt 2 -- 0 S City - W < What was your jah? J6#t n\j -hni X t?/~ - Mo <l {QngJ//ZC~_C_<U !f=S ~ fait 7 f S --to - 3_--_ _____ State. Solar Why did you leave? Ccy*/>A/>>/ j/\j if EMPLOYER'ZtZkiifly M k/ct^ro^h Uz a ._*<' rfflffjrnf" ^r<</tzc i ro * io___ .From (date). V Address________ ^ 7_6 g /Q_ AO 11_!. zJ._______________________ City C'h/. ^ m Y/img 6<r d/r/?-/ r >/ .State. What was your |ah? fP ). .Salary____ ^ Why did you leave?. EMPLOYER--------------- L 0 '~sJ .From (date). _to_ Address. City. . State. What was your job?. .Salary. Why did you leave?. EMPLOYER. Address_____ What was your job?. -From (date). .City. .to. . State. .Salary. Why did you leave?. Armed Forces Serial No. 3~ c\p&.r of Service. What kind of work do you do best? PSecond Best? Z- fyf# 1/^--------------- READ OVER THE DATA YOU HAVE GIVEN AND MAKE CERTAIN ALL THE REQUESTED INFORMATION HAS BEEN ACCURATELY AND COMPLETELY SUPPLIED. If additional space is needed, use reverse side. 1M 1046 M204 Clgnat...-, LmrtxJ^-------------------------------------------------------------------------------- CONFIDENTIAL in f o r ma t io n REDACTED CYWI 4-00136 N14540.01