| Surname and given names of head of family. | Total number of persons for whom rations are asked: | Food Card No. | Date of this registration. | |||
| Men | .......... | Children | .......... | |||
| Women | .......... | Aged, etc. | .......... | |||
| Present location. | Former home or address on April 17th. |
| Trade or occupation of head of family. | Age. | Nationality. | Union. | Former employer. |
| References, or other memoranda relating to employment: | ||||
| Membership in: (1) fraternal orders; (2) churches; (3) clubs: | ||||
| Address of friends to be communicated with: | ||||
| Present employment: | Is it steady? | Is applicant owner of real estate? If so, where? | ||
| Plans for future: | ||||
| Relief supplied (other than rations, including transportation): | ||||
| Remarks: | ||||
Above form as [illustration]
FIRST REGISTRATION CARD (REVERSE)
| F o o d C a r d I s s u e d. | D a t e. | |
| N o. |
| Data as to adult bread winners in family or party (not the applicant named on face of card). | ||||
| Name and sex | m.f. | m.f. | m.f. | m.f. |
| Age and nationality | ||||
| Trade or occupation | ||||
| Union | ||||
| Former employer | ||||
| References | ||||
| Present employment | ||||
| Future plans | ||||
| Remarks:— | ||||
Above form as [illustration]