◆ SpookStack

« 7 (MAIDEN) 4) ash - GTATE Se atTie Ss “PRESENT ADDRESS. SC ane Ti PRESENT PHONE NO. Sney Oo CUIAL SECURITY NO. resent woue aooness | Zong aTATE ere %@ DATE Of 812TH MALE [x] FEMALE CJ U.S. CINIZEN? GRD no [. 1 eye 1 YOU ARE NOY A USS. CITIZEN, INDICATE TYPE OF VISA Sf Sf V4 4g a FULL NAME OF SPOUSE Kc U2: U.S. MILITARY SERVICE? KV NO C} BRANCH OF SEE, 27 Dum 7 Cw ivf S -- TYPE OF DISCHARGE 42.6 77,.C con ae SELECTIVE Stmvice CLassiNncaTION 4977.0 / Discs fr ed _ in EMPLOYMENT DESIRED reeasifer EX)! SUMMER OTHER oe = EG NRING WHEN? sumed 4 TERN ‘ ? ARE YOU-A FORMER BOEING EMPLOYEE? = YES C] » IF YES, WHAT COMPANY Divi$:Ow — . eo ee ee i# YES, UNDER WHAT NAME | _ HAVE YOU EVER MADE OTHER EMPLOYMENT INQUIRIES TO BOEING? | ves / NO C) if VES, SXPLAIN BELOW =e ANY RELATIVES EMPLOYED BY BOEING? YES J NO | IF YES. Le ewe ee _— - oe be es ee NAME ANT @ELATIONSHIF TE ee ee ee ee er ood HAVE YOU ANY PHYSICAL DEFECTS?, YES C] NO iF YES, EXPLAIN “Ain art Ay, a OTHER THAN MINOR TRAFFIC VIOLATIONS HAVE YOU EVER BEEN ARRESTED? YES C1 N Ex] tert AEST —s pT CIF YES, EXPLAIN BELOW, GIVING EACH CHARGE, DATE, PLACK ANDO DISPOSITION) aA b6é moseormmenervonn | \ aA ons [ty monn ne a . + Ls 4 wrare : Ua 4032 5000 , DB Cooper-8451 ++ ~] = 18 a. i soe Ee . - oo _ ‘ ar. :