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It has not been edited and may therefore contain several errors.

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nuu h r>i that y? u can operate'
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(State whether alow, fajr, or rapid)
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f ? ?u* th*? followirtf hlark*. crivin&r dste* of employment and name* of all employer* for last ten year*.
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IMPORTANT! I?.****' use thi? vpace for jrivm# a history of youi I	or profewwonal experience during the pa*t Ur r?tr\
State portion* you have held, duties involved, rtapontibihties, etc. If in huMne** for self, Ntate typr of huaine**, frive ki.?v: *"v zi ufw, and reason-* for diarofitinuance.
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LOA.