QUALIFICATIONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT - BARNARD, EDWARD T.
Document Type:
Keywords:
Collection:
Document Number (FOIA) /ESDN (CREST):
0001459670
Release Decision:
RIPPUB
Original Classification:
U
Document Page Count:
7
Document Creation Date:
June 22, 2015
Document Release Date:
April 17, 2008
Sequence Number:
Case Number:
F-2007-01040
Publication Date:
March 27, 1967
File:
Attachment | Size |
---|---|
DOC_0001459670.pdf | 292.28 KB |
Body:
SET
~ i~'h filed Ini
I. EMP. SER. NO.
2. NAME fLasf.Firsf-Middlei ~ 3. SEX
a, GATE OF 91RTH
-
EDULE;'GRADEj STEP
5. SC
H
p~ /f
p
~
6, OSITION TITLE 8. OF"rICE OF ASSIGNMENT 9. LOCATION (Counfiy, Cdyl
'~~
r
SECTION It AGENCY OVERSEAS SERVICE
AREA i
_ 'YPE TOUR
FROM
TO
~~C~ =DU~RSEI~S SERVICE
~
(b) (1)
(b) ~~)
I
I
I
(b) (3)
SECTION tll EDUCATION
DEGREE
MAJOR FIELD
COLLEGE
YEAR
BA~w
SP.A"~I~SN .L~~'ERAT~RE'
`~aLE ~i~i~"~ -~ON~
:~~:
!I
FORM
I-oi e44J
Mfg. 2-67
QUALlFiCATiONS SUPPLEMENT TO PERSONAL HISTORY STATEMENT
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING. TYPE OR PRIN7. AVOID USING LIGHT COLORED INKS.
BIGGRAP4~IC AND POSITION DATA
APPROVED FOR RELEASE
DATE: FEB 2Q08
s~
(Wh Filleo' !n)
SEC1iON III EDUCATION (Conf'd)
HIGH SCHOOL
:AST HIGH SCHOOL ATTENDED
ADDRESS (Gry, Srore, County)
YEARS ATTENDED (F~om-To)
GRADUATE
Q YES ~ NO
COLiEGE OR UNIVERSITY STUDY
I
"
'
SUBJECT
YEARS ATTENDED
DEGREE
YEAR
NO. SEM I QTR.
e AND LOCATION OF COLLEGE
OR UNIVERSITY
NAM
I
MAJOR
MINOR
FROM - - TO - -
RECEIVED
RECEIVED
HRS. (Specify)
I
!I
r
i
12.
I
I
1
I
L
' S. 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.
j
TRADE, COMMERCIAL AND SPECIALQED SCHOOLS
r
! NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
I
I
2.
3,
OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE
~ NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
Imo. us~ria a ege o e orces,
Har-t~ord, Connecticut
~ ~oreign ervice s~i ute,
Arlinb on,.Virginia
National Cecusity Seriinar
International Carrmzunis~
1956
1957
z
z
US Air Force
~;; Bolling AF Base, D.C.
FAG Qverseas ~eratians
1961
2
i lnd_tvstrial College of Armed Farces,
j ~. Partls.nd, Maine
National Securit~r Seminar
1964
2
s.
~ AGENCY?SPONSORED EDUCATION
I Specify which, r{ any, of the education shown in Section III was Agency sponsored.
NAME AND ADDRESS Or SCHOOL STUDY OR.SPKiALIZATION
FROM
TO
NO. OF MONTHS
0'.~R Bu~ldinm DC
(. _
195
1960
~
2
(o`er
19C I
~
! ~i'Z.
4rientat
on
1962
-
i r~
~~
1~
1965
r
~.
~~
4
~= I
L_
SI
(Wh filed Ini
SECTION IV GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL
KNOWLEDGE ACQUIRED BY - -CHECK (X)
NAME OF REGIC~i
TYPE OF SPECIALZED
DATES OF TRAVEL
DATE & PLACE
WCRK
OR COUNTRY
KNOWLEDGE
OR RESIDENCE
OF STUDY
RESI-
DENCE
TRAVEL
STUDY
AS51GN-
MENT
~ - i7.1 S''i, 0
B -Economics
I
C -Politics
D - ?~ternational Relatio
s
E - Ini'or!~ation Co-Tnmu~ica
ions
dorld~ride
E
_ I, 36-~2 ~IYC
X
X
29293
929-33 Yale;
Western Europe
4,B,C,D
193-~-~
.UPI
X
X
X
929-33 Yale;
Eastern Europe
B,C, D
UPI
X
929-33 Yale,
Latin A~LLeric~~
B, D
U'PI
X
Yale;
Cuba
A
C
D
B
1937
UPI
x
x
,
,
,
SECTION V TYPING AND 57ENOGRAPHIC SKILLS
. TYPING (WPM)
~. SHORTHAND (WPM)
3. INDICATE SHORTHAND SYSTEM USED - -CHECK (,X) APPROPRIATE ITEM:
1~,5
~ GREGG ~ SPEEDWRITING Q STENOTYPE ~ 50pTECIFY:
4. INDICATE OTHER dUSINE5S MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING !'comptameter, mimeograph, card punch, etc.)
NONE
SECTION VI SPECIAL QUALIFICATIONS
!. LIST ALL H0881E5 AND SPORTS IN WHICH YOU ARE ACTIVE CR HAVE ACTIVELY PARTICIPATED. INDICATE YCUR PROFICIENCY IN EACH.
Ter~.i.s -- rusty.
Gardening -- strong bac'~.
2. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM J, SECTION V, LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TC CTHER EQUIPMENT AND
MACHINES SUCH AS OPERATION OF RADIO TRANSMITTERS findicote Cw speed, ,ending 8 recewing) 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.? ~NO
d. IF YOU HAVE ANSWERED 'YES" TO ITEM 3 ABOVE, INDICATE KIND OF LICENSE OR CERTIFICATION ANO THE ISSUING STATE.
5. FIRST LICENSE/CERTIFICATE (year of issue)
MUNICIPALITY, ETC: (Provide license registry number if known)
6. LATEST LICENSE/CERTIFICATE (year of issue)
7. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH VOU ARE (HE AUTHOR do NOT ;~bmrt copies unless requested). WDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING
(non-f
i
ctio
n
r scientific articles, general in feresf su bjecfs, noels, shod ;fdri es, efc.)
o
n
y
~
~
T
1V ~LY.li
8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED.
~~~
9. PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.
19~i-6 eras publicity director off' nlzred ~'~. Knop~, Inc,
SEC~?ET
(When filled In)
r5ECT10N VII MILITARY SERVICE
Cl1RRENT DRAFT STATUS
ARE YOU P.EGISTERED FOR THE DRAFTI ~ YES ? NO
2. SELECTIVE SERVICE CLASSIFICATION
13. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS
4. IF DETERRED, GIVE REASON
MILITARY SERVICE RECORD (Active Duty Only)
i. MILITARY ORGANIZATION (Army, Nosy, etc. - spedfyl
l~..rmy of the US.
2. BRANCH OR CORPS
Air Corps
3. DATES OF SERVICE (extended active duty)
FROM - - T~ ~2 T~
eJ
~~iar ~-6
s. STATUS (Regulor, Reset et.~7 -Jun 5~+
Us,
a. TITLE OF JOB
,,
-~ ~
5. DES
CRIPTIGN OF DUTIES
~'~E'C1~1..5 u
i, INCLUSIVE DATES From- To- 6y month d year)
2, LOCATION (country, Ci+yl
3. DIRECTORATE?OffICE OR DIVISION, BRANCH
4, TITLE OF JOB
5. GRADES HELD IN JOB
6. DESCRIPTION OF DUTIES
I. INCLUSIVE DATES (From-iu-by month d yearl
2. LOCATION ;Country, Gry)
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
5 E CR'~T
Wh Frfled Inj
2. LOCATION (Co~orry, C;ryl
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
4 4. TITLE OF JOB
5. GRADES HEID IN JOB
~6, DESCRIPTION OF DUTIES
1. INCLUSIVE DATES from- To- by month 8 yeor) 2. LOCATION (Country, ory%
4. TITLE OF JOB
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
5. GRADES HELD IN JOB
C DESCRIPTION OF DUTIES
I
II
I
`~
I
1
1. INCLUSIVE DATES (from-To_by month 6 yeo~!
2. LOCATION (Country, Gry)
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
4. TITLE OF JOB
5. vRADES HELD IN JOB
t. DESCRIPTION OP DUTIES
S~T
vVhe Filed In)
SECTION IX
MARITAL STATUS
1. PRESENT STATUS !Single, Marred, Widowed, Snp
aroled, divorced, Annulled, Remarried) SPECIFY:
2. NAME OF SPOUSE )Last)
No Change
,'F+rst)
;Midd(el
(Maiden)
3. DATE OF 91RiH
J. PLACE CF BIRTH (City, Slale, Couniryj
5. OCCUPATION
b. PRESENT EMPLOYER
i. CITIZENSHIP
9. FORMER CITIZENSHIPS) COUNTRY(IES)
9, DATE U. S. CITIZENSHIP ACQUIRED
I
SECTION X
DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
NAME
RELATIONSHIP DATE AND PLACE OF 91RTH ~
CITIZENSHIP
PERMANENT ADDRESS
)
US
~iC~'E: The following are
p
ysical_1J
i~d personally bT.zt n
t financ
'ally dependent,
Jar,~es T,l. T~iilliams
f
~t'=e}~-in-1.
~r 1085, Gl~~s~onp
J,C'I'
uy ord an? orlum
Guilford, Co-rs-~eeticttt
^harlO'f,'te Tr1. T~lilliarls
i>s
Sher-in-1
w 1885, We~hersfi
~,
'.~,G"I'
1 e sea aw _oa
Guilford, Connecticut
,
I
SECTION XI
PROFESSIONAL SOCIETIES AND OTHER ORGANQATIONS
DATE OF MEMBERSHIP
NAME AND CHAPTER
AOORESS (Number, Aree+, Ci+y, Sfate, Country)
FROM
TC
-
GATE
~~ ~~-v Yl
SIGNATURE OF EMPLOYEE
~