5. Present occupation, ____

6. Years of service in present occupation, ____

7. Years of service with present employer, ____

8. Number of previous employers (domestic occupations), ____

9. Whole number of years engaged in domestic occupations, ____

10. Present wages received, per week, $____; per month, $____

11. Highest wages received from previous employers, per week, $____; per month, $____

12. Lowest wages received from previous employers, per week, $____; per month, $____

13. Have you ever had any regular employment other than housework? ____

14. Name such kinds of employment, ____