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9. (a) Have you ever been examined by or filed an application with this Commission for any position in the U.S. Government service? ^[[Yes]] (Answer "Yes" or "No.")

(b) If so, give information indicated regarding each examination or application.{
Name each position for which you have been examined or for which application was filed.
In what cities were you examined?
Give approximate date of each examination or of filing application.
What was your rating in each case?

10. Have you any defect of limb, hand, or foot?
If so, describe it fully. ^[[No]]
Have you any defect of sight or hearing?
If so, describe it fully. ^[[No]]
Are you physically capable of a full discharge of the duties of the position sought? ^[[Yes]]

11. (a) What is the present state of your health? ^[[[[strikethrough]]Excellent[[/strikethrough]]]]
(a) ^[[Excellent]]
(b) Have you tuberculosis in any form? ^[[[[strikethrough]]No[[/strikethrough]]]] 
(b) ^[[No]]
(c) Have you ever been affected with this disease? ^[[[[strikethrough]]No.[[/strikethrough]]]] 
(c) ^[[No.]]
(d) Have you any physical deformity? If so, describe it fully.
(d) ^[[None]]
(e) During the past five years, have you had any disease, acute or chronic, of any nature whatever? If so, describe it fully and give the length of time you were incapacitated by reason thereof.
(e) ^[[None in the past five years but about [[strikethrough]]10 or[[/strikethrough]] 15 years ago I had pneumonia, from which I fully recovered.]]

12. Are the answers to each and all of the foregoing questions full and true to the best of your knowledge and belief? ^[[Yes.]]

If female, prefix "Miss" or "Mrs."

(Signature) ^[[Vernon Bailey]]
(Sign you first name in full, your middle initial or initials, if you have any, and your surname in full.)
(Post-office address) 1834 Kalorama Road, Washington, D.C.

JURAT OR OATH.
[The following oath may be taken at any place in the United States most convenient to candidate, before any NOTARY PUBLIC, or other officer authorized to administer oaths for general purposes, before whom the candidate must appear in person. THE OFFICER'S SIGNATURE MUST BE AUTHENTICATED BY OFFICIAL (IMPRESSION) SEAL. If the oath be take before a justice of the peace or other office who has not such seal, his official character must be certified by the clerk of court, secretary of state, or other proper officer, under official seal.]

Subscribed and sworn to before me by the above-named candidate this ^[[6th]], day of ^[[Feb.]], 192^[[5]], at .................., county of ....................., and State [or Territory or District] of ........................

[OFFICIAL IMPRESSION SEAL.]

(Signature of officer.)...................
(Official title.).........................

The official seal must not be omitted. 

6-1236

^[[Copied]]
Form 375.
Feb., 1921.

Application No. .........................

FORM
FOR 
PROFESSIONAL, SCIENTIFIC, OR TECHNICAL POSITIONS. 

NOTE. -The candidate will carefully fill ALL blank spaces. 

For position of ^[[Biologist]]
(Give exact title of position or examination.)

in the ^[[Biological Survey, U.S. Department Aquenture.]] Service.
("Departmental," "Indian," "Engineer," etc.)

N. B.-Candidate will write plainly his full name (and if a woman, whether Miss or Mrs.) and post-office address in the blanks below. The address here given will be treated as the candidate's post-office address until notification of change is made to the Commission in writing.

Name of Candidate,} ^[[Vernon Bailey]]
Number and street, ^[[1834 Kalorama Road]]
Post Office, ^[[Washington]]
County, .....................
State or Territory, ^[[D.C.]]