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-. F:i::sr.-ii~ESresd! -- -- ~ ecoK 3 467 ~ ~ - • '=~: Original H.... • ••------- ew Ac't... ..-.----.....__._.....Reopen Ac't....._._.___...---------.......Add on Ac't...._......-.......---•------- --• ... ......--------...---• ... Foreman) ................._...__ ..__........... _. (Now Long Emplo7ed) ( (Address) _.Plant ......................_..--..........-..._...---........... Badge No._......-----~~~'~~•- (Nature of Wort) Credit References--------------•--•----- ....-.. -------------------------------._..............- --r---....._..._ . Wife or Husband's ame--..... . --------- A1 arried .....................Single.....-----........... - ---------- ---------------------..-..-......_Ad ress---.........-----•.-.-.-........_----....._----•----...-..._. _. Father's Name .............~~-------•----- Mothers Name---------------------------------------------------------------:....ress....^-------.... .h ...........Ad~-:------ ................A .....---.................-.....-.-........_.... 114dse. or ........................ ..~,. ~-......... .~ ~ ddress 1 till T^, i-f~ ~J C~ • - ~ ..... ~ ~ .` ~0 R+ '' Y - ~..-.._......-..... • .gyp. -----.---_....-°---- fii...~Q..rt'5.~......__... _ . z `•• Sold >• s ,, o. REMh ~`' a ~ ; - o f' y~ - .r 1 .: ~4t t r ~ 7 O " W IJ~r p~ ! -.~ .Ni 3 •.' S ~ h: :~' d~~„e ~ Hirt-r-c!_~ r _~~ ~; m~y~ -- - r~-- ,-. Now long-. ----------..._-- Previous Address._............_......._._.._...___...__.__-----.----_._