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SHANDARD EQRM 97 h ALICATION FOR FEDERAL EMPLOYML... ~~~ US CIVIL SERVICE COMMISSION 1 Kind of position applied for or name of exammation DO NOT WRITE IN THIS BLOCK Consultant,Presidents Commission For Use of on Seouri Civil Service Commision Only 2 Opaen(s) (+f ardtys is examimation announcement} Matersal Entered Register, qo Subautced 3. Place of employment applied for (esty and State) Q Recurned On add Notations: App Review? (Favs? name) (Marden, 1} any) % ba 5. Street and number or R D number ~ > enewra Flo cs City of post Office (:nciuding postal zone} and State a 6 Place of birth City -...Fargo,. Stare or foreiga country _._North. Dekota, 7 Date of buth (month, day, year) APPLICATION NO. & (4s] Male Oct. 30,1908 FE Mal 10 Toitaals Fi Married and ‘Date (J Singte 12 Legal or voung reaidence (State) Plorida, Dates of service un that grads rom May 2949 to Mar .§4 “hen retired, per 14 AVAILABILITY INFORMATION A ladicate the lowest salary you will accept $ You wail nol be constdered for any position with a lower entrance salary C Wail you accept appomtment for 1 to 3 months? a} 3 to 6 months? CT} 6 ta 12 months? Acceptance or refusal of a short-term abposmtment wll not affect your consideration for another spposntment D Are you willing to travel (XOccasonaily? [| Frequently? |_| Constantly? E Wall you accept appointment In Washington, D C ? CJ Anywhere in United States? { | Outside U S? BE. Uf you will accept appointment only in certaia locations, ise chem 7 13 VETERAN’PREFERENCE A if you claim 5-foint" preference Based on wartime mulstary service, indicate Date(s) of entry into actrve service | Date(s) of separation Branch of service Serual number If none, give grade or (Army, Navy, Air Force, ee} rating at separation B Do you claim $ point preference as a peacetime campaign veteran? C Do you clam 10 point preference? D Have you ever been ated 10-point veteran preference or 5 point preference as a peacetime campaign veteran by the U S Civil Service Commission? Yes 5 No If so, Sarcace below the office which granted this preference to you Attach your Potice of preference allowance if available It will be returned to you Name of U § Crvil Service Commission office or name of Board of U S | Address of Commussion office or Board of Exanuners Cavil Service Examiners . City ------- ~~ nae ee ten ence ne eee ieee ween eeenenenceenceceeen THIS SPACE FOR USE OF APPOINTING OFFICER ONLY The information contamed 1n answer to question 15A has been verified with the discharge certificate, which shows that the separation was under honorable conditions, Bg gumh Signature ~.~220 ny anne renee nee en emer en. neon ener nen eee neers (Continued on next page) 16--53046-3