SECRET
(When Filled In)

SECTION V
GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL
NAME OF REGION OR COUNTRY
TYPE OF SPECIALIZED KNOWLEDGE
DATE & PLACE OF TRAVEL
LANGUAGE
CULTURAL
ECONOMIC
SCIENTIFIC
OTHER

SECTION VI
TYPING AND STENOGRAPHIC SKILLS
INDICATE TYPING SPEED (WPM): _______ INDICATE STENOGRAPHIC SPEED (WPM): _______

SECTION VII
SPECIAL QUALIFICATIONS
PROVIDE INFORMATION ON HOBBIES, SPORTS, LICENSES, PUBLICATIONS, MEDALS OR SERVICE PRIOR TO THIS DATE, INVENTIONS:

SECTION VIII
MILITARY SERVICE
CURRENT DRAFT STATUS
1. HAS YOUR SELECTIVE SERVICE CLASSIFICATION CHANGED? IF YES, CLASSIFICATION: _______
2. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS: _______

MILITARY RESERVE, NATIONAL GUARD STATUS
3. CHECK RESERVE OR GUARD BRANCH TO WHICH YOU BELONG:
ARMY
NAVY
AIR FORCE
MARINE CORPS
COAST GUARD
NATIONAL GUARD
AIR NATIONAL GUARD

4. CURRENT RANK, GRADE OR RATE: _______ DATE OF APPOINTMENT IN CURRENT RANK: _______
5. EXPLANATION OF DUTY OR CONTRIBUTION: _______
6. CHECK CURRENT RESERVE CATEGORY:
READY RESERVE
STANDBY RESERVE
RETIRED RESERVE
DISCHARGED
7. MILITARY MOBILIZATION ASSIGNMENT: _______
8. MILITARY SCHOOLS COMPLETED (Standard or Technical):
NAME AND ADDRESS OF SCHOOL: _______
STUDY OR SPECIALIZATION: _______
DATE COMPLETED: _______

SECTION IX
PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS
NAME AND CHAPTER: _______
ADDRESS (Number, Street, City, State, Country): _______
TITLE OR POSITION: _______

SECTION X
REMARKS

DATE: _______
SIGNATURE OF EMPLOYEE: _______