28. Have you been inoculated against Enteric Fever?

If so, what date?

If not, are you willing to be?

Have you been vaccinated?

It so, what date?

If not, are you willing to be?

29. Your usual Occupation or Profession?

Your present Occupation or Profession?

30. Give the Names and Addresses of two British Householders with permanent addresses in the British Isles who have known applicant for two or more years, but are not related to applicant, to act as References, having previously obtained their permission to use their names.

(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 Are you willing to serve in Civil Hospitals from which personnel have been withdrawn for War Service?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.

Date .......... Usual Signature ..........

_For Office Purposes_, please add your full Christian Names and Surname legibly written.

I certify that the above declaration is, to the best of my knowledge and belief, true; and that M ............ is a fit and proper person to be employed by the Joint V.A.D. Committee.

REMARKS:--

Date .......... Signed ....................

_Commandant_.

Date .......... Countersigned ....................

_County Director_.

NOTE.--Commandants are held responsible for all statements on this form being accurate so far as it is possible for them to find out, also for the fact that the member who signs it is a British subject, and in every way suitable for appointment by the Joint V.A.D. Committee.

This form must be signed by the Commandant, who should then send it to the County Director for counter signature and forwarding to Headquarters.

_Application No._

_For Official use only_.

CONFIDENTIAL.

WOMEN'S ARMY AUXILIARY CORPS FORM OF APPLICATION

N.B.--No woman need apply who is not prepared to offer her services for the duration of the war and to take up work wherever she is required.

1. Name in Full (Mrs. or Miss).

2. Permanent Postal Address.

2a. State nearest Railway Station.

3. Surname at birth, if different.

4. For what work do you offer your services? State your qualifications for this work. (The occupations for which women are required are set out in the accompanying leaflet.)

5. Are you willing to serve:-- (a) At Home and Abroad as may be required.

(b) At Home only.

6. If selected and enrolled how many days' notice will you require before your services are available?

7. Age and date of birth.

8. Place and Country of Birth.

9. Nationality at Birth.

10. Present Nationality (if naturalised give date).

11. Whether single, married or widow.

If married state number of children, (a) under 12 years old.