324 SOCIAL DISEASES AND 



Corps. 



Division. 



18 



(single) 

 FORM OF APPLICATION 



FOR AX APPOINTMENT AS AN 



OFFICER IX THE SALYATIOX ARMY 



Name 



Address 



1 . What was your AGE last birthday ? What is 



the date of your birthday ? 



2. AVhat is your height? 



3. Are you free from bodily defect or disease ? 



4. What serious illnesses have you had, and when ? 



5. Have you ever had fits of any kind ? If so 



how long ago, and what kind ? 



6. Do you consider your health good, and that you are strong 



enough for the work of an Officer ? If not, 



or if you are doubtful, write a letter and explain the 

 matter 



7. Is your doctor's certificate a full and correct statement so 



far as you know ? 



8. Are you, or have you ever been married / 



