PERSONAL HISTORY STATEMENT - BARNARD, EDWARD T.

• Document Type: FOIA
• Keywords: PERSONNEL FILES
• Keywords: BARNARD EDWARD T
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001459673
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 12
• Document Creation Date: June 22, 2015
• Document Release Date: April 17, 2008
• Case Number: F-2007-01040
• Publication Date: January 25, 1946

(b) (3)
(b) (6)
PERSONAL HISTORY STATEMENT
Instructions: 1. Answer all questions completely. If question does not apply write "not applicable."
Write "unknown" only if you do not know the answer and cannot obtain the answer
from personal records. Use a separate sheet for extra details on any question or
questions for which you do not have sufficient room.
2. Attach 2 recent passport size pictures to this form, date taken written. on the back
of each.
3. Type, print or write carefully; illegible or incomplete forms will not receive consid-
eration.
HAVE YOU READ AND UNDERSTOOD THE INSTRUCTIONS? ..... yep ..
Yes or Na
SEC. 1. PERSONAL BACKGROUND
~~'~ ~dv~?~.rd Townasnd Farna.rd P?lhairL $-0528
A. FULL NAME ..~ .......................................... TELEPHONE ................. .
s.'
PRESENT ADDRESS ...53. Ch~;stnu~..$venue,...Pslhenx.6.5,...iy~w~l+7rk ..UuA......... .
St.:~ No. City State Country
LEGAL RESIDENCE ...~a'`~~
St. 8: No. City State Country
B. NICKNAME ..... ~ ............................... ANY OTHER NAMES THAT YOU HAVE USED .......... .
...........none ......................UNDER WHAT CIRCUMSTANCES HAVE YOU EVER USED THESE
NAMES? .........................................................................
HOW LONG? ............... IF A LEGAL CHANGE, GIVE PARTICULARS` .......... , ...................... .
.............................................................................................................
Where By What Authority?
10/i10~19I0 ~tev~r Rochelle, tVY LISA.
C. DATE OF BIRTH ...... ................. PLACE OF BIRTH .' ........................... ................ .
City State Country
US US
RACIAL ORIGIN THROUGH MOTHER ......................THROUGH FATHER .......................... .
D. PRESENT CITIZENSHIP 11S ................... BY BIRTH? yeS ......... BY MARRIAGE? ............. .
BY NATURALIZATION CERTIFICATE ~ ..................ISSUED .................... BY ................ . .
Date Court
AT .. ..................................................:...................................................
City State Country
HA~7E YOU HAD A PREVIOUS NATIONALITY? .....NO............ WHAT? ................................. .
csss) HELD BETWEEN WHti`1 DATES? ............... TO .............. ~..~Y OTRER NATIONALITY? ............ .
? APPROVED FOR RELEASE
DATE: FEB 2008
 HAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIP? .NE?........... GIVE PARTICULARS: .
E. LAST U.S. PASSPORT: NUMBER, DATE AND PLACE OF ISSUE ................:.`......:......:........
Issued. in. spring..af..1929..in.:~`as.hingtcn;..vp:.~aed.~.oz?. E~aglaz~d,. F~~..nce., . Belgitam......
HOW MANY OTHER U.S. PASSPORTS HAVE YOU HAD? ..lyOk'l@ .. GIVE APPROXIMATE DATES:
PASSPORTS OF OTHER NATIONS? ........ TwOT1~ .........................:..................... . .......... .
F. IF BORN OUTSIDE U.S. WHEN DID YOU FIRST ARRIVE IN THIS COUNTRY? ........................ .
PORT OF ENTRY? ..........................:... ON PASSPORT OF WHAT COUNTRY? ...............
LAST U.S. VISA .............................................
.............................................
Number Type Place of Issue Date of Issue
SEC. 2. PHYSICAL DESCRIPTION
35 male
SEX e n
AGE ............ ........ HEIGHT ..5. 8 .............. WEIGH~`~6.......
EYES .blue........ HAIR .broWx~ ........ ... COMPLEXION .. f~??' .......... SCARS~?one, , , , . , , . ? . , .
BUILD ..medium ............... .........: OTHER DISTINGUISHIATG FEATURES . g.las,ses,........ .
SEC. 3. FATHER (Give the same information for Step-father and~or guardian on a separate sheet)
Everett Larkin. Barnard
FULL NAME ................. ............................... .....................................:.......
First Middle Last
LIVING OR DECEASED .... living ~ DATE OF DECEASE ................ CAUSE .............
12 Boulevard, Rochelle Fork, ~~ewRocl^.elle, i~ewYork
PRESENT, OR LAST, ADDRESS .............................. ............................................ .
St. & No. City ,,, State Country
~ a ~~ Calai S ~:ine ~.
DATE OF BIRTH .14 ~?Ct ?~f PLACE OF BIRTH .... ............................................. .
CITIZENSHIP ........ WHEN ACQUIRED? WHERE? .............................. ..............
City State Counppr
Retired (lawyer) Cr~,xrch E Gates ~ Co, Inc tc~efunct
OCCUPATION ................................. LAST EMPLOYER .... ..............
152 St & mast rLiver, NevrYcrk
EMPLOYER'S OR OWN BUSINESS ADDRESS ........ ....... ...................................... ..... .
St. 8s No. City State Country
I~'LILITARY SERVICE FROM IkOI16 Gate ~ TO Date BRANCH OF SERVICE ........ .
COUNTRY ........ DETAILS OF OTHER GoV"T' SERVICE, U. S. OR FOREIGN .....
_._
.....
(663) .............s...........:.........,=OT1P,............................:......................................
 SEC. 4. MOTHER (Give the s~ ormlation for Step-mother on a s sheet)
Theri~a Tc~vvnserad Barnard ?
FULL NAME ..............................................::.
.............
First Maiden Last
~. 7. L'3. ~.~
LIVING OR DECEASED ....................... DATE OF DECEASE ............. , .. GAUSS ............ .
__
12 sou3svard, Rocr~$lle Parlk, `?e~ ~~cri~l~.e, lue~ xoric .
PRESENT, OR LAST, ADDRESS ..:.............................................................. .
St. & No. City State Country
DATE OF BIRTH ...............~~. PLACE OF BIRTH ...{~~ ~ .~ .:.......................... .
~~ 'Z`Ft~ ~~r)~ $ ~?~ State Country
CITIZENSHIP ..... WHEN ACQUIRED? ~J~T"~l'1 . WHERE? .... ..........:..... . ............. , ...... .
City State Country
hOLiS85Y1,f8
OCCUPATION .......................:............ LAST EMPLOYER ... ~~-~-......:............ .
EMPLOYER'S OR OWN BUSINESS ADDRESS .: .............. .............................................
St. & No. City State Country
DETAILS OF GOVT SERVICE, U.S. OR FOREIGN IIOZl? ..... ................ . ................ . ... . .. . .. .
SEC. 5. BROTHERS AND SISTERS {Including half-, step-, and adopted i~rothers and sisters)
(IF YOU HAVE BEEN MARRIED MORE THAN ONCE USE A SEPARATE SHEET
FOR FORMER WIFE OR HUSBAND AND GIVE REQUIRED DATA FOR ALL PRE-
VIOUS MARRIAGES)
SEC. 6. MARITAL STATUS
A. SINGLE .............. MARRIED..Ye~ , . , ..... DIVORCED................ WIDOWED- ................ .
STATE DATE, PLACE AND REASON FOR SEPARATION OR DIVORCE ................................. .
PRESENT ADDRESS ......................................... ..........
..................................
St. & No. City State Country
FULL NAME .....~ ..............................:......
First Middle Last
PRESENT ADDRESS .................... .............................................
St. ~ No. City State Country
..................................
State Country
PLACE 3e~i&ue~t~1~J~~,~.5.'i,@ . .
......... DATE OF MARRIAGE ........ .
LIVING OR DECEASED .liv:in,~ ........... DATE OF DECEASE .............. CAUSE
...............
 SEC. 6. MARITAL STATUS (Cont'd)
DATE OF BIRTH. . , 22 April I?]~ACE OF BIRTH.. ~s.rtford, Conn
City .State Country
RACIAL ORIGIN THROUGH FATHER..~J ............. THROUGH MOTHER .~ ~...... .
birth
CITIZENSHIP.. jJj .... WHEN ACQUIRED?...... ..... WHERE? ...... .
hau6ewi fE City state Country
OCCUPATION ......................................... LAST EMPLOYERT31o~~ito~t-Donatrazi .
School, New .Rochelle .N"
EMFLOYER'S OR OWN BUSINESS ADDRESS .............. ........................................ ... . .
St. & No. City State Country
MILITARY SERVICE FROM....n~~~. BRANCH OF SERVICE ..........
COUNTRY ...................... DETAILS OF OTHER GOVT. SERVICE, U.S. OR FOREIGN ............. .
none
FULL NAME...~Ta?i?es, Dillard ~Villiaris
................. ..............................................
First Middle Last
LIVING OR DECEASED.. IiY1T1~" .......................... DATE OF DECEASE ..........
PRESENT, OR LAST, ADDRESS..Gstr&,rrprDur~r:~er..AC&d~ric~t~ '~O~ztl~?$~2'?lE1ttsytat~~s~? Country
_ Clastonbtzry, ~onn?
RACIAL ORIGIN .............................. BIRTH ..'. .. .. ! ~~.~ ................. .
....................
Date : City Country
'JS ~ birth ;
CITIZENSHIP ... ..... WHEN ACQUIRED? .......... WHERE?
......................... .......:......
City State Country
Charlotte ~Telles ~~`; lliams
FULL NAME .. ....... ....................................
First Malden Last
LIVING OR DECEASED, ..??~'~'~
DATE OF DECEASE .......................
PRESENT, OR LAST, ADDRESS ..................
~p
~o#e~or L~umraer Aca~ . youth , fief! to ~ .
1 L~ 9f .~3s Country
RACIAL ORIGIN.. ~ ......................... BIRTH. F f ~ ~?.... ~~e~hersfield, Conr~~
Date City Country
CITIZENSHIP..~j$...:. WHEN ACQUIRED?...bi.rth. WHERE? .....
City
State ~ Country
SEC. 9. CHILDREN OR DEPENDENTS (Include partial dependents)
NAME ........ RELATIONSHIP dau liter
g.,........... AGE
NATIONALITY US .. , ..................... ADDRES~
NAME
RELATIONSHTP SQ?Z ..................... AGE
NATIONALITY .. L'~, .. ~ .................... ADDRESS .
? o? ty tae Country
NAME :..X .............................. RELATIONSHIP AGE .......
NATTONAL,ITY ........... ADDRESS ..... .
(603 ~ ,-- St. & No. ' Gity State Country
 SEC. 10. RELATIVES BY BLOC. ._ .~RRIAGE OR ADOPTION, WHC ABROAD, ARE UNDER THE
JURISDICTION OF A FOREIGN POWER ARE NOT CITIZENS OF' THE UNITEI3 STATES, OR
ARE MARRIED TO NON-CITIZENS
NAME ~... pj'ori~. ~ ...................... RELATIONSHIP .......................... AGE ......... .
NATIONALITY .... ADDRESS . ..
. .............................................
5t. ~ No. City State Country,
REASON FOR LISTING UNDER TIIIS QUESTION .......... .............................................
NAME ........................................ RELATIONSHIP ...... .. .AGE
NATIONALITY' .......... ADDRESS ....... ........................................... .
St. 8: No. City State Country
REASON FOR LISTING UNDER THIS QUESTION . ........ ...........................................
NAlU1E ....................................... RELATIONSHIP .... ..................... AGE ..........
NATIONALITY ..................... ADDRESS ....... ............................................ .
St. & No. City State Cauntry
REASON FOR LISTING UNDER- THIS QUESTION ....... .. .............:.. ? ........................... .
SEC. 11. RELATIVES BY BLOOD OR MARRIAGE; IN MILITARY, NAVAL OR OTHER GOVT SERVICE -
U,S. OR FOREIGN:
NAM ............ RELATIONSIII AGE .........
NATIONALITY ............................ ADDRE~ ....... .. ~
St. & No. City State Cauntry
LTS
NA1tiIE X~
..................... RELATIONSHIP ................. , ........ AGE ........ .
NATIONALITY .................. ADDRESS ....... .................. .
.........................:
St. Fi No. City State Country
TYPE AND LOCATION OF SERVICE (IF KNOWN) .......... ............................................ .
NAME ....................................... RELATIONSHIP ...................... , ... AGE ......... .
NATIONALITY ............................ ADDRESS....... ...............................,..:..........
St. & No. City State Cauntry
SEC. 12. GIVE FIVE CHARACTER REFERENCES-IN THE U.S.-(Give business addresses where possible)
State
 SEC. 13. NAMES OF 5 PERSONS ~~HO KNOW YOU SOCIALLY IN THE UNITED STATES. NOT REFER-
ENCES OR EMPLOYERS-(Give business addresses where possible)
3. NAME ADDRESS I I
4. NAM ADDRESS:
5, NAM
. ....City ..............State...
SEC. 14, GIVE THREE NEIGHBORS AT YOUR LAST NORMAL RESIDENCE IN THE U.S.
NAME : ........................................ ADDRESS ... ...................
St. & No. City .......... .. State . .
NAME : .......... ............................. ADDRESS
St, & No. City State
NAME : ....................................~... ADDRESS ..........
St. & No. City State
Loomis School ~indsor,Cann
SCHOOL : ................. .................. ADDRESS ..... ..
....................:.......................
City State Country
Is24-IQ~9
DATES ATTENDED : ................ .............. DEGREE ..graduated
........................
SCHOOL : .:.................................. ADDRESS ... -. m
Cfty State Country
DATES ATTENDED : .....................................DEGREE ............... .
...................
COLLEGE: ... X.&le.. u~.ige.rSaty.. , .... , .. ADDRESS 1`lew~v?n, Conn'
...................................................
Citp State Country
DATES ATTENDED: ...~"~~~~ 1933 B?A,e
.. DEGREE ...................................
COLLEGE~indlebur~% ~pa.nish School ADDRESS B~?c~dlebury Vt
....................:............
City State Country
DATES ATTENDED;1932 -- Special 6-zvkS Course
.........................DEGREE ........:................
SEC. 16. MILITARY, NAVAL OR OTHER GOVT SERVICE - U.~S. OR FOREIGN
England AAF Capt
Country Service Rank
479 Fighter Group, F~377 ,p_9p~464
............ h
Last Station Serial No. Type of discharge ~ om. cer
REMARKS: ~>~*~~tier act? ~e duty l7 June 42; first assignrient I~e~r~`or~ ~.ir '~efer~se
2ng, ;~ Zrid asaigrinierit ~~ston Air Lef' ~lg; ~Boaton;.:,3~rd ~assi.g~arfent
366th ~`ighter Group until June 44, thence to 479th ~`~igh~e_ Group at
9C~.ttishar-...,~F'.,.. Suffolk; ~ England ................................................ ..... .
1944-945
 j.'r~=' ~1-~
SEC. 17. SELECTIVE SERVICE ._ .iS
l 7 Jixr ~ 42:
CLASSIFICATION . r~:_, ~~~..~~.} .... ORDER NO. ..... .... APPROX. INDUCTION DATE .....:....... .
BOARD NO. .737..... ADDRESS ..~ev+~C.hells~, . ~ .... ................................ .:..:..... .
SEC. 1S. HAVE YOU EVER SEEN DISCHARGED FROM ANY POSITION, OR LEFT UNDER CIRCUM-
STANCES WHICH WERE NOT ENTIRELY FAVORABLE? PLEASE GIVE DETAILS
SEC. 19. MISCELLANEOUS
DID YOU EVER HAVE OR DO YOU NOW fiAVE MEMBERSHIP iN, OR SUPPORT, ANY POLITICAL PARTY
OR ORGANIZATION WHICH ADVOCATES THE OVERTHROW OF OUR CONSTITUTIONAL FORM OF
GOVERNMENT IN THE UNITED STATES? . ??a ...:..........IF "YES," EXPLAIN: .................... .
inf',requently ........................... .
HAVE YOU EVER BEEN ARRESTED, INDICTED OR CONVICTED FOPS ANY VIOLATION OF LAW OTHER
THAN A MINOR TRAFFIC VIOLATION? IF SO, STATE NAME OF COURfi, CITY, STATE, COUNTRY, NATURE
OF OFFENSE AND DISPOSITION OF CASE ....... ~? ....... .................................. , .
SEC. 20. FINANCIAL BACKGROUND
ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY?~e$.. IF NOT, STATE SOURCES OF OTHER
INCOME ....................
NAMES AND ADDRESSES OF BANKS WITH WHICH YOU HAVE ACCOUNTS ......................
central rational Branoh, First i`~atl $ank, ~7ea~ Rochelle, NY
.........Peop3.e's ~Bank~ soz- Ba-?rirt~s~; ~=~~nrR'och'ells;..~ew ~o.,-~ ......:............................ .
HAVE YOU EVER BEEN IN BANKRUPTCY? I1Q ....... GIVE PARTICULARS ....................... .
 -SEC. 20. FINANCIAL BACKGROUND (Cont'd)
GIVE three CREDIT REFERENCES - I?~T TfIE U.S. ~O to ? none v~ rth mentioning because
always buy for cash.
Huguenot `j`rust Co ~f0rmer mortgagor)
NAME : ....................................... ADDRESS .~9Tr~ ,~O.Gh9,lle, : F119~YOI`1G .... .
St. & No. Cfty State
Wirth ? s .Garage Pelrtamdale eve, Pe lYa~t NY
NAME : ....................................... ADDRESS ... .............:.
Westchester Lighting Co tlewst~ocPielle NH ~city ................atiate
NAME: ......... ADDRESS ..........
St. & No. City State
SEC. 21. CHRONOLOGICAL HISTORY OF EMPLOYMENT FOR PAST IO YEARS. INCLUDE CASUAL
EMPLOYMENT. INCLUDE ALSO PERIODS OF UNEMPLOYMENT. GIVE ADDRESS AND STATE
WIiAT YOU DID DURING PERIODS OF UNEMPLOYMENT. INCLUDE LAST 5 POSITIONS AND
COVER AT LEAST 10 YEARS.
EMPLOYER479th FighterCroup, A.AF Group Intell officer
................... TITLE OF JOB ..........
ADDRESS APC~, 559, .rbstmaster NY
........................oit......
St.& No. .....................................
y State Country
YOUR DUTIES AND SPECIALTY . Research, . ,pre.paratiar. c~? briefings for fighter of c
......
......
e0rabat missions in the ETQ
KIND OF BUSINESS : .................................... . NAME OF SUPERVISOR ........... .
FROM: .~Turi@ ~~.r:6p.t . 4.5 . TO : ...................... SALARY ~ ... La ptai2?.. PER ................. .
REASONS FOR LEAVING Return. tc ~S to inactive duty .
...................................................
EMPLOYER Cnited PreSe ~ssociatio~~s Asst ~dltor
..................................:...... TITLE OF JOB ..........
...................
220 mast ~ 5t, ~eR York Cite
ADDRESS ........................
................................................
St. R No. City ...........Country
State
YOUR DUTIES AND SPECIALTYI;dltirxg,,..ppxoee.ssing,,. transriitting v~arldwide ne~?s
abraact to foreig
2i
t~
..... .
n c
er
I
KIND OF BUSINESS: ..ldev~s agency NAME OF SUPERVISOR,
.... ,.. _., __ 8C wk
FROM : ...................... TO: ~sALARY
$..... PER ..................
REASONS FOR. LEAVING .... Z'gO
rld ~~ar II
.
...................................................
Time Inc. Circ ~br of `Fyetters?`
-- .......................... ....... TITLE OF JOB
Rockefeller P]a za, T~e~w Yark City
ADDRESS ... .
.......................................
St. 8> No. City .................Country
State
r 1
YOUR DUTIES AND SPECIALTY Ci_ cu~.ati:>r~ promotion production
.......................... ..........................
KIND OF BUSINESS:ma~azine publishers NAME OF SUPERVISOR .........
1936 1937 ~ .
.............
FROM: TO : ...................... SALARY ~. I50C~........ PER . y~~T', ......... .
~sss~ REASONS FOR LEA~~h--~, ~.'Preferer_ce far news irk
 CHRONOLOGICAL HIS,'-~~~r (Cont'd)
Chlxzich ~ uates ~ Co ~ - ,r noaas
EMPLOYER ............................ TITLE OF JOB ..........
152 St ~ =jest River, !`~e,3rYork
ADDRESS ................................................ .
...................:........................
St. & No. City State Country
YOUR DUTIES AND SPECIALTY- ~,ereral. i.ac.tr~L~.~-~,;, sales:nas~, collector; office wank
KIND OF BUSINESS: Umber merchants NAME OF SUPERVISO .......
1933 1935 ?
FROM : ...................... TO: ...................... SALARY $ ..... ~ ........ PER ................. .
REASONS FOR LEAVING , . , Dl ~ 3 t 1 Ike it .
.......................................................................
EMPLOYER ,Yale University -~- student
........................... TITLE OF JOB ...........................
ADDRESS .........................
St. 3z No. City State Country
YOUR DUTIES AND SPECIALTY ........................... ............:................................
KIND OF BUSINESS: ........ . ................. NAME OF SUPERVISOR ................... .
FROM : ...................... TO: ...................... SALARY $ .............. PER ................. .
REASONS FOR LEAVING .................................. ..........................................
SEC. 22. RESIDENCES FOR THE PAST TEN YEARS
53 Chestnut Avenue, relham 65, l~ev: York ripril 1945 date.
.....................................:................... FROM: ............ TO: ............
St. & No. City State _ _ Country
297 Eastchester Road , lyew Rochelle ? 1~ewYork 1939 1945
.............................. ........................................... FROM: ............ TO: .........
St. & No. Clty State Country
12 Boulevard, iiew. Rochell.eP..=~~ew Yfl.rk ......................... FROM: .1938.... , . TO: 1939
St. & No. City State Country
647 ~~est 169 ~?tree~t, tiewYOrk City 1935 1938
........................................................................... FROM: ............ TO: .........
St, & No. Clty State Country
................................................................ .......... FROM: ............ TO: ............
St. & No. City State Country
............................................... ........................... FROM: ............ TO: ............
St. & No. City State Country
.............................. .
........................................ FROM: ............ TO: .:..........
St. & No. City State Country
..............................................:........................... FROM: ............ TO: .,..........
St. & No. City State Country
SEC. 23. RESIDENCE OR TRAVEL OUTSIDE THE UNITED STATES
Except for mil service, o rn,~y two trips outside eontinerital US:
.~ ~ DATES .July .1929..... TO .dept 1,929... .
En~}.a?nd...~'ra.nce .. e?lgaum .................... trauey ..... .
G~ty or Sectio~ Country Purpose Month & Year Month & Year
Cuba -- 9-day cruise Deb 1938 (s)
...... ........................................ DATES .................. TO .................
City or Section Country Purpose Month & Year Month & Year
 SEC. 23 RESIDENCE OR TRAVEL (Cont'd)
........................... DATES
.....City~or Section Count ......................... ... ......... TO ...
ry Purpose Month & Year Month & Year
................................................ DATES TO
. ? ? ~ City or Section
Country p
urpose .Month & Year Month & Year
............................................ DATES To .
..................
ty or Section
Country Purpose Month & Year Month & Year
.. .... .. ' DATES TO
City or Section Count " " " ' ? '
rY
Purpose Month & Year Month & Year
SEC. 24. CLUBS, SOCIETIES AND OTHER ORGANIZATIONS
LIST NAMES AND ADDRESSES OF ALL CLUBS, SOCIETIES, LABOR UNIONS, PROFESSIONAL SOCIE-
TIES, EMPLOYEE GROUPS, ORGANIZATIONS OF ANY KIND (INCLUDE MEMBERSHIP IN OR SUPPORT
OF ANY ORGANIZATION HAVING HEADQUARTERS OR BRANCH IN A FOREIGN COUNTRY) TO WHIGH
YOU HAVE BELONGED:
informally contribute to ydle ~niversit,;u ax~~ in. turn its sup;~ort of the
...............Yale. mission in Chines
.............................................................
Name ......... ......
St. & No. City State Country
Name .....................................................
St. & No. City State Country
................................................
Name .................................................
St. & No. City State Country
Name """?'
......City ..............State........... Country...
St. & No.
...........................................5............................
Name ...................................
St. & No. City State Country
Name ........................
....................y..
St. & No . ..............City........ State Countr
Name .............. City............. State ...........Country .. .
St. & No.
Name ..............Cit..........
St. & No. ............................. .
y State Country
SEC. 25. RELIGIOUS AFFILIATION
CHURCH OF ATTENDANCE ..... St ? ?~atzl ` s l epi s copal ~ Churr'rl
'yew ~acY~el.'~e~ '!tia:^r~"crk
~
ADDRESS .................................. NAME OF MIIv'ISTER OR PRIEST .... .
SEC. 26. GENERAL QUALIFICATIONS
A. FOREIGN LANGUAGES (STATE DEGREE OR PROFICIENCY AS "SLIGHT" "FAIR" OR "FLUENT")
LANGUAGE ............~ra~"iiur fluent fluent fair
................. SPEAK - .....:...... RE ~D ........... WRITE .......... .
LANGUAGE Rrench fair fair slight
..:........... SPEAK RE_~D .: WRITE .......
LANGUAGE .................................. SPEAK
READ ........... WRITE ...........
LANGUAGE .................................. SPEAK
... READ ........... WRITE ..........
LANGUAGE ......................... . ........ SPEAK ........ .
?~;AD ........... WRITE ...........
WRITE .........., -AGE ..................................
_ '" SPEAK ............ PLEAD ......... .
 . } _
SEC. 28 GENERAL QUALIFICA7'r`Z?''~' (Cont'd)
? B. HAVE YOU ANY SPECIAL KNOWLEDGE OR TRAINING WITH RESPECT TO;
MOTOP~ VEHICLES? ...... ~~ AIRPLA~iES? ~~...... RADIO? Ti4~
GIVE PARTICULARS .............~................................................,......................
L. LIST all SPORTS AND HOBBIES WHICH INTEREST-YOU; INDICATE DEGREE OF PROFICIENCY IN EACIi.
i!~ 'uS' :i~'~llU"' ttd~.rt`'~.Di~.i+: '? '`' r~n +? ....:... .wherefores,;, , . ? .
. ~~..~ ...~...~ 3......, . `....... S. 3...Ir.;,E_ _~s.,.icnal affairs -- ~rhys
Literature, ~~'C!e:C'iC?i,71, English, Spanish, "rEriCi2
'~`~rriti::g, short storia.s;. ~rerse.
All a3merican ~~ Sri ~ysh spo~r~s ~.s ~obsever, played tennis In coll~e~e
................................................................:...........................................
............................................................................................................
............................................................................................................
D. HAVE YOU ANY QUALIFICATIONS, AS A RESULT OF TRAINING OR EXPERIENCE, WHICH MIGHT FIT
YOU FOR A PARTICULAR POSITION?
Lx~erience in news edit:.ng ca1_.ing for fast analysis ~ cGrrect disp csitzc _ ci
:)erg"~L1eTi; ;,^.d.~E:ri.f.l~ ~)2 ~ @~r,S ~Yi _ly I.T.!*~~1~ Ei:CB CBiiirig i'Or analysts,
evaluation, disposition ~ ~br~e*?'ing. .. .
.............................................................................................................
............. ..............................................................................................
state country
 SEC. 28. YOU ARE INFORMED THAT .THE CORRECTNESS OF ALL STATEMENTS MADE HEREIN. WILL
BE INVESTIGATED, AND YOU ARE INVITED TO MAKE ANY CHANGES (OR ADDITIONS} IN
YOUR STATEMENTS THAT YOU MAY THINK ADVISABLE.
A, ARE THERE ANY UNFAVORABLE INCIDENTS IN YOUR LIFE NOT MENTIONED ABOVE WHICx MAY BE
DISCOVERED IN SUBSEQUENT INVESTIGATION, WHETHER YOU WERE DIRECTLY INVOLVED OR NOT,
WHICH MIGIiT REQUIRE EXPLANATION? IF SO, DESCRIBE. IF--NOT, ANSWER, "NO."
.............. ~o
..........................................................
..........................................................
B. I CERTIFY THAT THE FOREGOING ANSWERS ARE TRUE AND CORRECT TO TIIE BEST OF MY KNOWL-
EDGE AND BELIEF, AND I AGREE THAT ANY MISSTATEMENT OP, OMISSION AS TO A MATERIAL FACT
WILL CONSTITUTE GROUrIDS FOP IMT~IEDIATE DISMISSAL.
........~ Stness ' ........................ .......~ .~;. .?....... .
Signature of applicaxii
Applicant will not write belaw
COMMENTS OF INTERVIEWER:
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