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,;xI¤»ri:s:\§%I;¤y FEDERAL WORKS AGENCY
l  A ~‘r:r‘iU
WORK PROJECTS ADMINISTRATION
   
mf ____ _ __________________ ( ______________ WORK HISTORY Dm, _________________________ __ __________4_ _
____ ‘ . Answer ull items——Write legibly
[uune .....................¤........,............. - ......._.......I.............._......4..... - ...................EE,,. . K.E.......A.,.,..
  Qslidrlle) _ (Last)
lfli 1 ' (Do rnortrgidlgihihis space)
Mailing audI‘0SS ......... . ....*... - ..................... - ...... .. .............. - .......,.............  
Hi (Numbcr or R. F. D.) (Street) __ ('Town or city) ((E%2 _ __ __M
iax and race:   l\llale lj Female lj   Wliitie I] Negro Q Other _4_.____A_______.______
· · ~· rlnigte by e check) a _' A (Spec@;)_
"""*"""""""""‘ . . I . . ' .
» Date ol birth ,_...._..... - ,.......... - .......,..,   Height .......¤..._ ft., ............ 1n.   `Weight ............4,E.. lb.
(Day) (Month) (Year) I
_ Explain fully any physical defects, disabilities, or trouble with your health and state whether they hinder your
. I work .... A __..........................................................,.e.................._......... - .......................l..__..........
2  I -— —---------—-——--—-»-——— — ——---»—--—--- -- —-—----»—--—-----~------------—------—-—-—---—----------——---——-—---—-—-——-----—·---------------~—---»·-—-V--
'“"e.~e,' ‘ —   · · Y I . .
v- Q . Tlur. CIUCSIZIOII 1S to be answered only by laborers, Am you physically able LO do hafd manual labor?
{  rnanual Workers, or persons \V1ll1Dg to accept Y U Y I;]
. _ _ . ' assignment at such work. (/S * O
.. L ,,   . . . _”—— "‘—
  h,lueat1on—Incl1cate years of schooling completed by circling number:
3 7  
, Elementary I Hig/2. school College I Other (specify kind and number of years eomplelwl)
°  c_}._jij_ 4 5 6 I
___P·I2345678I1234 Degrees: I
I  . . ILANGEAGE (CHECK FOR ENGLISH, srhcrrr ANY ornmzsl
;,  llajors or special courses:  
  Larqcumn SPEAK Run I Warm;
i — ».  I English .______ . ...___,__,_,__,__ . ...._.__....___r, I _..,____..........
-———-_——__-..1   . . . mma--mum mmmmwm nmnuu-mm ummm-mm
. .... . . . , . Q llliat do you consider your regular trade or occupation or line of work?
 il How did you learn to do this work?
.  List trade organizations and vocational or professional societies to which you belong and state length of
" , _  1IIC‘l’Ill)•2I'Sl11pZ
,   _   List unexpired trade, professional, or driver’s licenses:
i i Lisl office, factory, road, or construction machines you can operate:
 , lliis question is to be answered only by mechanics   D0 YOU have thi? tOOl$ customarily Owned by m€9h8U'
- · ·   or craftsrpen OI other skilled workers: ies in your trade? Yes Q No Q
» EMPLOYMENT RECORD
Q Mart with your last job—List all jobs lasting more than a month, not including CWA, PERA, and W PA.
~ lie very specific about the kmd of work you did. lf you drove a truck, tell what size truck and kind of mate- _
I nal hauled. lf you were a clerk, tell whether you were a sales or record or audit clerk. ln box headed
"wage," tell whether it was hourly, weekly, or monthly. List all periods during which you worked for
yourself or were farming. There is sufficient space for listing 8 jobs, if more space is needed add another
  sheet.
,  
  5;.,ND WAGES Er.rrr.0i?rgi;;;¤EEA;LeDA(;1;\t;.nnnEss I KIND OF BUSINESS I Yom: Jos Txrreqgljgsgigu KIND or Worm
i i · NIH __ __________ Name; I
0 ..e._ _ __________ _ _______________ _____ __________________________
Address: ‘
· I Tom ____________ I Name:
I. .___ _ _______ ___ _______________________ __ __________ _ _______ ___ I
OOO4O'A'L I Address: I
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