Residence

......................................................................................................

School or place of Employment} ..........................................................

Date ...........

If the Applicant requires the second Ticket (on which only works that are not Fiction may be drawn), the following should be signed:

I desire to receive a Non-Fiction Ticket

....................................................

Signature.

Fig. 136.—Front of Voucher for Non-Resident Student or Employee;
the back is the same as in [Fig. 135].