QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT - CARANCI, JOHN C.

• Document Type: FOIA
• Keywords: CARANCI JOHN C
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0001496511
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 5
• Document Creation Date: June 22, 2015
• Document Release Date: December 31, 2008
• Case Number: F-2007-00327
• Publication Date: October 10, 1969

SET
(Whe filled In)
QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING. TYPE OR PRINT. AVOID USING LIGHT COLORED INKS.
SECTION 1 BIOGRAPHIC AND POSITION DATA
I, EMP. SER. NO.
2. NAME (Last-First-Middle)
3. SEX
4. DATE OF BIRTH
S. SCHEDULE/GRADE/STEP
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'GS 110
6. . OSITION TITLE 8. OFFICE OF ASSIGNMENT 9. LOCATION (Country; City)
TECH WA,
SECTION 11 AGENCY OVERSEAS SERVICE
AREA
FROM
TO
E
1--
.2 2 Sll~
APPROVED FOR RELEASE^DATE:
12-Nov-2008
J : ?..n
1 B PqOV1969
SECTION III EDUCATION
DEGREE
MAJOR FIELD
COLLEGE
YEAR
NC ;CGLLEGE :DEGREE ON RECORD
, ~ FORM
444J SE E 7 14-51).
$ 2-67
 SEC
( her filled In)
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HIGH SCHOOL
LAST HIGH SCHOOL ATTENDED
ADDRESS (City, Stote, Country)
YEARS ATTENDED (From-To)
GRADUATE
YES ^ NO
COLLEGE OR UNIVERSITY STUDY
ND LOCATION OF CO
NA
E
EGE OR UNIVER
I
SUBJECT
YEARS ATTENDED
DEGREE
YEAR
NO. SEM / QTR.
M
A
LL
TY
S
MAJOR
MINOR
FROM - - TO - -
RECEIVED
RECEIVED
HRS. (Specify)
2.
4. ...;., ,..,,,
;
5. 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
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
2.
OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
1.
2.
3.
4.
5.
AGENCY-SPONSORED EDUCATION
Specify which, if any, of the education shown in Section III was Agency sponsored.
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
2.
3.
4.
5.
1
-2-
 SE
(W// FNIT
ed In)
SECTION IV GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL
KNOWLEDGE ACQUIRED BY CHECK !X)
NAME OF REGION
OR COUNTRY
TYPE OF SPECIALIZED
KNOWLEDGE
DATES OF TRAVEL
OR RESIDENCE
DATE & PLACE
OF STUDY
RESI-
DENCE
TRAVEL
STUDY
WORK
ASSIGN-
MENT
SECTION V TYPING AND STENOGRAPHIC SKILLS
1. TYPING (WPM)
2. SHORTHAND (WPM)
3. INDICATE SHORTHAND SYSTEM USED - - CHECK (X) APPROPRIATE ITEM:
GREGG E] SPEEDWRITING 0 STENOTYPE Q SPECIFY:
4. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (comptometer, mimeograph, card punch, etc.)
SECTION VI SPECIAL QUALIFICATIONS
1. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY IN EACy
-yu
2. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 4, SECTION V, LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND
MACHINES SUCH AS OPERATION OF RADIO TRANSMITTERS (indicate CW speed, sending & receiving) OFFSET PRESS, TURRET LATHE, EDP AND OTHER SCIENTIFIC & PROFESSIONAL DEVICES.
3. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION SUCH AS PILOT, ? YES
ELECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL TECHNICIAN, PSYCHOLOGIST, PHYSICIAN, ETC.? G
4. IF YOU HAVE ANSWERED 'YES' TO ITEM 3 ABOVE, INDICATE KIND OF LICENSE OR CERTIFICATION AND THE ISSUING STATE.
MUNICIPALITY, ETC. (Provide license registry number if known) S- ~7 y f r- h' '#t Al
if k
5. FIRST LICENSE/CERTIFICATE (year of issue)
J 0 /li"ndl Sys y ofc,01 ..a"j "r /may/Seo+el-
r W/4 k -~1~ r R- ,
6. LATEST LICENSE/CERTIFICATE' year of issue)
7. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE i AUTHOR (do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING
(non-fiction or scientific articles, general interest subjects, novels, short stories, etc.)
8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED.
9. PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.
 SET
(Wh n r illed In)
SECTION VIi MILITARY SERVICE
CURRENT DRAFT STATUS
ARE YOU REGISTERED FOR THE DRAFT? fl YES l_-NO
2. SELECTIVE SERVICE CLASSIFICATION
LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS
A. IF DEFERRED, GIVE REASON
MILITARY SERVICE RECORD (Active Duty Only)
1. MILITARY ORGANIZATION (Army, Navy, etc. - specify)
9 1 S & i-0
)
2. BRANCH OR CORPS
3. DATES OF SERVICE (extended active duty)
FROM-- TO--
4. STATUS (Regular, Reserve, etc - specify)
D15C L'~
5, RANK, GRADE OR RATE (of separation it post service)
6. SERIAL, SERVICE OR FILE NUMBER
7. - PIOL HONORABLE DISCHARGE ^ RETIREMENT FOR SERVICE ^ UNDUE HARDSHIPS
CHECK TYPE OF F-1 RELEASE TO INACTIVE DUTY F1 RETIREMENT FOR COMBAT DISABILITY ^ OTHER.(Specify)
SEPARATION
^ RETIREMENT FOR AGE ^ RETIREMENT FOR PHYSICAL DISABILITY
8. BRIEF DESCRIPTION OF MILITARY DUTIES (rocord the duties and skills which best describe your work or function in the military service).
J Glll~ b1~~7 ~y J `~~
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MILITARY RESERVE, NATIONAL GUARD STATUS
CHECK RESERVE OR GUARD ORGANI- ^ ARMY ^ MARINE CORP;fA ^ NATIONAL GUARD
ZATION TO WHICH YOU BELONG ^ COAST GUARD
^ NAVY ^ AIR FORCE ^ AIR NATIONAL GUARD
1. CURRENT RANK, GRADE OR RATE
2. DATE OF APPOINTMENT IN CURRENT RANK
3. EXPIRATION DATE OF CURRENT RESERVE OBLIGATION
4. CHECK CURRENT RESERVE CATEGORY ^ READY RESERVE ^ STANDBY (active) STANDBY (inactive)
RETIRED DISCHARGED
5. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES (record the duties and skills which best describe your work or function in the, military service).
6. IF YOU ARE CURRENTLY ASSIGNED TO A RESERVE OR NATIONAL GUARD TRAINING UNIT, IDENTIFY THE UNIT AND ITS ADDRESS.
MILITARY SCHOOLS COMPLETED (Active Duty, Reserve Status or as Civilian)
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
DATE COMPLETED
RESIDENT
~( ~K.-[Y..`c,?rs~7 Y
c
CORRESPONDENCE
I ? ~~ ~.
O t
AGENCY-SPONSORED
f
RESIDENT
CORRESPONDENCE
2.
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
3.
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
4?
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
5.
AGENCY-SPONSORED
!'4-
 SE T
(When Filled In)
SECTION IX MARITAL STATUS
1. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, Annulled, Remarried) SPECIFY:
2. NAME OF SPOUSE (Lost) (Fiat) (Middle) IMoidenl
3. DATE OF BIRTH
4. PLACE OF BIRTH (City, State, Country)
5. OCCUPATION
6. PRESENT EMPLOYER
7. CITIZENSHIP
8. FORMER CITIZENSHIPS) COUNTRY(IES)
9. DATE U. S. CITIZENSHIP ACQUIRED
SECTION X DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
NAME
RELATIONSHIP
DATE AND PLACE OF BIRTH
CITIZENSHIP
PERMANENT ADDRESS
SECTION XI PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS
DATE OF MEMBERSHIP
NAME AND CHAPTER
ADDRESS (Number, Street, City, State, Country)
FROM
TO
DATE
SIGNATURE OF EMPLOYEE