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D B Cooper — Part 36
Page 61
61 / 483
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11" 4, Date and place of birth... BIL ent Lirtihe... neni etl. 7
} : Cay. town, oF county) (kate or countzy) :
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1 ' 5. Are you a citizen of the United States? 0.06 eeecennrecnnrpeeenecsaverenenscsavarer cena cienstoetesvansenenrnrdenssvesacrntaanenn 0 ef
; . ' (Uf a naturabzed citizen, state how, when, to 4
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7. Have you ever been convicted of any crime by a civil court? oe PEL cerca Military court? Sp € cnemarrveunnah-orenu |
PPT ee eee ret) tists Steere eee ee een Pe tT Hasna menace Pee eee ete et ett ete te hee Bhi Peet Perec eer re tT y
8. I (have) Cheve-nct) had previous military service. Natzrnal Pome
9. I (have) (have not) been previously eliminated from Army, Navy, Marine Corps, or Coast Guard flight training because of
deficiency in flying or other reason . If previously eliminated, state date and school or station from which
tee tie ore eri a) ee ene ers wre Perens en nee ee nee ce ey a pienso eee eee ee ee mtr acc Err vate on
10. ¥ (have) (have not) taken previous aviation cadet mental and/or physical examination, (If previously taken, : state whether
mental, physical or both and give date, place, and results) ccc csasnceasarot-ersernacpacnevessnesuwarnmannonearanstvecescaiernannencayese
A Ape ees 9 ie en er pense Or OR me ACRE ES $26 EAE NORA td 4e—— SRE ROR AA ROR Es ee PO er OE ET CRRA EOE EER ROSE EE Ae WE Se Ee nee ED
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ORR 86 heer ele One Re ee ee OO ee Ae 2 PE O48 On Ty Ones Ye eR eee EE REE heres a aRE eR Sh eT RAPES er h we dans a
OW I understand and agree that: rer
' @) Belore fi an be appointed tion cadet E must first successfull reheved of appointment as aviation cadet # such appointment 9) ' «
complete * preliminary course rene and classifcation in caksted ae. acconiplishe poi continued in the service in an enlisted statun
© rte 2 , fhemband oiet) (2) Upon successful completion of the he ies course of ‘training | wih
Assignment toas type of training e7, Navigator, OF accept cither an appointment as officer or commission as, second © ite
ermained upon the basis of psychological eptitude classification Keutenant, whichever noay be tendered me, ae
an tests. ‘+ - § Qe) If acceptance for this training is secured by means of false statement, sa
rae C2 if Teil fer ac reason to complete the course of tra inchading | failure willful misrepresentation, or concealment as to qualifications, J will be a
the che ining, 5
here oe sssification tests, f will be removed froma further air crew liable to relief from further air crew training, stare er at
won ®. (We), parent(s) or guardian(s) of an ignacure of applicant) ones ane
aah , 1 iene of pga ATR ENCR meine team owOS amt odneven eran’ 4 ‘
; , consent toa ‘ _ a
_ pplication. {To be filled in and signed only if applicant is under 18 years of age.) ro ae
ras . ' + fee 4 “a me .
re ! | CAUTION: SPECIAL HANDLING REQUIRED oy
a 7 ' This nt gr{6X SOpteK Trowreconts Nattonal!
a $i Personnel Records Center, St. Louis, Miesoard. , aur, : 3%
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* tetters of recommen fritt, be submitted. in duplicate accompanied wmdisseninare in tt iginal Porm outside” oa eae 4
_ eee eaten Bette a ea re eee as fall nceel vee
wd 34 ' vow, Dd, A. 6. oO. Porga No. 65 , , oe « apt neh S te aR Bee ae
ake ae | 26 Sune 1943 ' ' sow ' : oO my “yp es teks d t,
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u yy woyphooe ! obs %," ‘a 5 Vm att FO . :" at ‘Oe | at . 1 r
atte ts OF DB COOpErLOSZOFY UM ee eg tg STMT EA a, 4
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