(a) (Mayor, Magistrate, Justice of the Peace, Minister of Religion,
Barrister, Physician, Solicitor or Notary Public).
Acquaintance dating from year ________
(b) Lady.
Acquaintance dating from year _______
31. Name and Address of Head of College or School, recent Business Employer, Head of Government Department, Secretary of Society or some other person who can be referred to for a report on your qualifications for the work selected. (The Quartermaster of your V.A.D. could be given if you have worked in her department.)
In what capacity employed?
How long employed?
Year?
32. Are you willing to serve at home or abroad?
33. Are you willing to serve in Civil Hospitals from which personnel have been withdrawn for War Service?
34. Are you willing to serve:--
(a) With pay,
(b) For expenses only,
on the terms of service laid down in our terms of service?
N. B.--Members who can afford to work for their expenses only are urgently needed.
35. Date after which you will be available for duty.
36. (a) Are you pledged to serve in any other organisation? (b) If so, what?
37. (a) Have you served with the Women's Legion or any similar organisation?
(b) If so, what?
I hereby declare that the above statements are complete and correct to the best of my knowledge and belief.