5. Are you willing to serve:-- (a) At Home and Abroad as may be required. (b) At Home only. 6. If selected and enrolled how many days' notice will you require before your services are available? 7. Age and date of birth. 8. Place and Country of Birth. 9. Nationality at Birth. 10. Present Nationality (if naturalised give date). 11. Whether single, married or widow. If married state number of children, (a) under 12 years old. (b) " 5 " " 12. If not single state Nationality of Husband. (a) Is your husband serving with the Forces? (b) If so, where? 13. Father's Nationality at Birth. 14. Mother's Nationality at Birth. 15. Father's Occupation. 16. State school or college where educated. At what age did you leave School? 17. Particulars of any other Training, stating Certificates held. 18. (a) Name and Address of your present employer (_see Note on other side_). N.B.--(The employer will not be referred to unless he is given as a reference under paragraph 20 below.) (b) Nature of his business. (c) Capacity in which you are employed. (d) Length of your service with him. (e) Salary which you are now receiving. 19. Previous business experience (if any) giving dates, salaries received, and names of Employers. 20. Give below for purposes of reference the names of two or more British householders with their permanent addresses, one of whom should be, if possible, your present or previous Employer, a Teacher, a Town Councillor, Mayor or Provost, Justice of Peace, Minister of Religion, Doctor or Solicitor, who has known you for two or more years, but is not related to you. One of the references must be a woman. (a) Name. Profession or Occupation. Address. (b) Name. Profession or Occupation. Address. (c) Name. Profession or Occupation. Address. An offer of Service can in no way be regarded as a final enrolment. _I hereby declare that the above statements are complete and correct to the best of my knowledge and belief_. _Date_ ___________ _Usual Signature_ ____________ This Form should be filled in by the Applicant and returned to:--Employment Exchange _________________________ * * * * * NOTE. Women who are already engaged in any of the following occupations will not be accepted unless they bring with them a letter from their Employer or Head of Department stating that they have permission to volunteer:-- (i) Government Service. (ii) Munition work. (iii) Work in a Controlled Establishment. (iv) Full-time work in an establishment engaged on contract work for a Government Department. (v) V.A.D. Military Hospitals and Red Cross Hospitals. (vi) School Teaching. (vii) Local Government Service. No woman who is a National Service Volunteer or is employed in Agriculture will be accepted.