SECRET
(When Filled In)
QUALIFICATIONS UPDATE
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING. TYPE OR PRINT. AVOID USING LIGHT COLORED INKS.
Most recent qualifications are a matter of computer record; they must be periodically updated. This is done automatically for much information; however, some must be obtained directly from you. This form is for that purpose. Specific items must be updated at intervals. When you receive this form, carefully check your personal records to ensure that all information is current and correct. Qualifications submitted on this form will be entered into your computer record. If you are in doubt whether information has been previously submitted, enter it in the appropriate section. Then sign and return this form to the National Registry Administrative channels to the File Room, Office of Personnel, Room 5E-11. Additional, corrected, or updated information may be added at any time there is information to be added or changed simply by completing and returning an updated form as your initiative.
SECTION I
BIOGRAPHIC AND PROMOTION DATA
NAME (Last, First, Middle) MODEL, James DATE OF BIRTH 19 March 1931
EMPLOYEE NO. 05392 COPY NO. 1
SECTION II
COLLEGE OR UNIVERSITY STUDY
NAME AND LOCATION OF COLLEGE OR UNIVERSITY SUBJECT YEARS ATTENDED DEGREE YEAR MAJOR MINOR
FROM TO RECEIVED RECEIVED
If a graduate degree has been noted above which required submission of a written thesis, indicate the title of the thesis and briefly describe its content.
TRADE, COMMERCIAL, AND SPECIALIZED SCHOOLS
NAME AND ADDRESS OF SCHOOL TYPE OF SPECIALIZATION FROM TO NO. OF MONTHS
OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE
NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION FROM TO NO. OF MONTHS
SECTION III
MARITAL STATUS
PRESENT STATUS (Single, Married, Widowed, Divorced, Separated, Annulled) and SPECIFY
NAME OF SPOUSE (Last) (First) (Middle) (Maiden)
DATE OF BIRTH PLACE OF BIRTH (City, State, Country)
OCCUPATION PRESENT EMPLOYER
CITIZENSHIP (If foreign citizenship(s) countries) DATE U.S. CITIZENSHIP ACQUIRED
DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
RELATIONSHIP NAME AND PLACE OF BIRTH CITIZENSHIP PERMANENT ADDRESS
SECRET
Form 494m 15 AUG 1968