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Form 15 (revised)
2-1-29—10M

SUBMIT A PHOTOGRAPH TAKEN WITHIN THE LAST 2 YEARS 

CIVIL AERONAUTICS AUTHORITY

APPLICATION FOR EMPLOYMENT 

Instructions.—Read all questions carefully. Give complete and specific answers. Use a separate sheet wherever additional space is required. If this application does not present a complete statement of your qualifications, experience, and ability, it is desirable to submit a written supplement accompanied by exhibits or samples which illustrate these factors. Please type if possible.

RETURN TO PERSONNEL OFFICE

Do not use this space

Date
I. Name (First) (Middle) (Last) Maiden name
Residence telephone Business telephone 
Address: Street City State ,Since , 19
Last previous address City State  ,Since , 19
Age Date of birth Birthplace Citizen of 
[[8 Columned Table]]
| DESCRIPTION | PERSONAL | DEPENDENTS Description | DEPENDENTS No. | DEPENDENTS Ages | ANY PYSICAL DEFECTS | ANY PYSICAL DEFECTS | In case of emergency send word to: |
|---|---|---|---|---|---|---|---|
| Male [[checkbox]] | Single | Description | No. | Ages| Sight [[checkbox]] | Feet [[checkbox]] | Name
| Female [[checkbox]] | Married Yrs | Wife-husband |   |   | Hearing [[checkbox]] | Hand [[checkbox]] |   |
| Height | Widowed [[checkbox]] | Children |   |   | Speech [[checkbox]] | Others [[checkbox]] | Street Phone |
| Weight | Divorced [[checkbox]] | Parents |   |   | Describe: |   |   |
| Color | Separated [[checkbox]] | Others |   |   |   |   | City |

Date of last physical exam. , 19 Purpose Result
Time lost through illness 2 years days, weeks, months. Present health
II. 1. Are you at present employed by the U. S. Government in a civil-service position? Yes No
2. If you are now employed by the U. S. Government in probational status, give date on which you will complete your probationary period
3. Do you have eligibility for appointment to the competitive classified service?
(a) Reinstatement (b) Transfer (c) From an eligible register
4. Are you eligible for: Permanent or Temporary appointment?
5. If you have been employed in any branch of the U. S. Government give the exact date of pay roll termination if recent
6. If you are listed on a civil-service register(s), give name of register(s)
7. What Federal, State, or other merit examinations have you taken in the last 5 years?
[[4 Columned Table]]
| TITLE OF EXAMINATION | CONDUCTED BY WHAT COMMISSION | DATE | GRADE |
|---|---|---|---|

8. Position desired 9. What salary do you expect? $
10. Will you accept temporary employment? 11. How soon could you start work?
(1)
16-8177