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N. Nav. 353
Rev. Oct. 1938

APPLICATION FOR COMMISSION IN U.S. NAVAL RESERVE

(Date)
From: (Name is full) (Address)
To: The Chief of the Bureau of Navigation.
Via: The Commandant, Naval District.
Subject: Application for appointment as USNR.
Enclosure: (a) Evidence of citizenship.
(b) Letters of recommendation (at least three).
(c) Official transcript of prior military service. (Transcript of prior U.S. naval service not required.)
1. I request that I be appointed in the U. S. Naval Reserve (Rank)(Corps, class, etc.)

2. The following information concerning the undersigned is furnished for consideration:
(a) Date and place of birth
(b) Citizenship (N. U.S.) (Date of naturalization) (U.S.)
(c) Education (Schools and colleges attended or graduated from with dates and degrees awarded)
(d)Languages Conversation Translation 
   (Indicate proficiency under "Conversation" and/or "Translation" by words "Indifferent," "Fair," or "Excellent.")
e) Associations 
f) Military or naval or Coast Guard Service                                             (Give dates, organizations, ranks, and/or ratings, etc., of former and present service)
g) State whether at present a member of any Federal or State military organization in an active, reserve, or retired status 
j) If ever granted a pension, compensation for disability, or retired pay, or if claim for such is pending, state dates and circumstances 

(OVER)  4-7137 

Transcription Notes:
Blank form.