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Have you any special qualifications, such as mechanical, electrical, radio, airplane rigging, etc.?
Do you hold a Dept. Commerce license?: Airplane (yes or no) No. Engine (yes or no) No. Radio operator (yes or no) No. Parachute rigger (yes or no) No. 
On what types and makes of airplane engine have you had considerable experience.
(a) Overhauling
(b) Maintaining and trouble shooting

NAMES OF LAST EMPLOYERS
|  | SALARY AND POSITION HELD | KIND OF BUSINESS | DATES GIVE MONTH AND YEAR |
| --- | --- | --- | --- |
| Name Address Why did you leave? |  |  | From To |
| Name Address Why did you leave? |  |  | From To |
| Name Address Why did you leave? |  |  | From To |
| Name Address Why did you leave? |  |  | From To |
| Name Address Why did you leave? |  |  | From To |

If this application is favorably considered will you accept assignment to any of the Company's stations in South America?
Have you had experience in foreign countries (State number of years, country, kind of service)
If not employed at present, state reason
State amount and source of private income
State amount and nature of any personal insurance carried by you