Name ______________________________________________________________________
Address ___________________________________________________________________
? ___________________Whatisthedateofyourbirthday? ____________________________
?__________________
?_____
, andwhen? __________________________________________________________________________________________________
?_____________________________Ifsohowlong, andwhatkind? ___________________________________________
, andthatyouarestrongenoughfortheworkofanofficer? _________________________________________________Ifnot, orifyouaredoubtful, writealetterandexplainthematter.
'scertificateafullandcorrectstatementsofarasyouknow? _______________________________________________________________
, orhaveyoueverbeen, married?_______
?_____________
? __________________________________________________________________________________________________
?______________Ifso, howlong? _________________________________________________________
? ___________ andsignedArticlesofWar?_______________________
, saywhatandhowlongheld? _______________________________________________________________________________
? ______________________________________________
?______________ Ifso, howlong? ________________________________________
? _________________________________________________________________ DateofyourRestoration? ___________________
? __________________ Ifso,howmuch? ______________________
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