QUALIFICATION UPDATE - COLLINS, CHARLES P.
Document Type:
Keywords:
Collection:
Document Number (FOIA) /ESDN (CREST):
0001426171
Release Decision:
RIPPUB
Original Classification:
U
Document Page Count:
9
Document Creation Date:
June 22, 2015
Document Release Date:
March 20, 2008
Sequence Number:
Case Number:
F-2007-01041
Publication Date:
June 22, 1967
File:
Attachment | Size |
---|---|
DOC_0001426171.pdf | 398.62 KB |
Body:
(b) (2)
(b) (3)
QUALIFICATIONS UPDATE
READ INSTRUCTIONS CAREFULLY BEFORE COMPLETING, TYPE OR PRINT, AVOID USING LIGHT COLORED INKS
Now that your qualifications are a matter of computer record, they must be periodically updated. This is done auto-
matically for much information; however, some must be obtained directly from you. This form is for that purpose.
Section I must be completed in all cases. You need provide other information only if there have been changes since
you submitted your Form 444j, "Qualifications Supplement to the Personal History Statement," or a previous update form.
If you are in doubt whether information has been previously submitted, enter it in the appropriate section. The si ned
and dated form should be returned through administrative channels to the File Room, Office of Personnel, Room
Headquarters, whether information is added or not.
Additionally, a qualifications update may take place at any time there is information to be added or changed simply
by completing and returning an update form on your initiative.
SECTION I BIOGRAPHIC AND POSITION DATA
EMP. SER. NO. NAME (Last-First-Middle)
COLLINS, Charles P.
DATE OF BIRTH
12/28/16
SECTION II EDUCATION
HIGH SCHOOL
LAST HIGH SCHOOL ATTENDED
ADDRESS (City,State,Country)
YEARS ATTENDED (From-To)
GRADUATE
Q YES ^ NO
COLL
EGE OR UNIVERSITY STUDY
TY
SUBJECT
YEARS ATTENDED
DEGREE
YEAR
NO. SEM/QTR.
NAME AND LOCATION OF COLLEGE OR UNIVERSI
MAJOR
MINOR
FROM--TO--
RECEIVED
RECEIVE
D HRS.(Spec-Fy)
2.
IF A GRADUATE DEGREE HAS BEEN NOTED ABOVE WHICH REQUIRED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE OF THE
THESIS AND BRIEFLY DESCRIBE ITS CONTENT.
TRADE, COMM#RCI AL AND SPECI ALLZED- SCHOOLS
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
OTHER NON- AGENCY EDUCATION OR TRAINING NOT INDICATED ABOV E
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
SECTION III MARITAL STATUS
1. PRESENT STATUS (Single,Warried,Widowed,Separated,Divorced,Annulled,Remarried) SPECIFY:
2. NAME OF SPOUSE (Last) (First) ("fiddle) (Maiden)
3. DATE OF BIRTH
4. PLACE OF BIRTH (City,State,Country)
DATE: DEC 2007
5. OCCUPATION
6. PRESENT EMPLOYER
7. CITIZENSHIP
8. FORMER CITIZENSHIP(S) COUNTRY(IES)
9. DATE U.S. CITIZENSHIP ACQUIRED
SECTION IV DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
NAME
RELATIONSHIP
DATE AND PLACE OF BIRTH
CITIZENSHIP
PERMANENT ADDRESS
ADD
1. 0
DELETE
ADD
2 U DELETE
FORM 4144n SEJET
2- 68 'T ew ( n
SECTION V -~- GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL
NAME O
1: f;~ F
r;'O
A
'
KNOWLEDGE ACQUIRED BY- -CHECK M
F REGION
OR COUNTRY
TYPE OF SPECIALIZED
KNOWLEDGE
DATES OP TRAW,FfL
+'
OR RESIDENCE
TE
ACE
- O,
I 0C
V
OF STUDY
Rest'
JENCE T
RAVEL
STUDV
WORK
ASS IAN.
MENT
.
Y 9 1 26
2?
SECTION VI TYPING AND STENOGRAPHIC SKI_
1. TYPING (WPM)
2.SHORTHAND(WPM)
'3. INDICATE SHORTHAND SYSTEM USED--CHECK (X) APPROPRIATE ITEM.
GREGG SPEEDWRITING STENOTYPE
^ El ^ SPECRIFY:
SECTION VII SPECIAL QUALdFICATIONS
PROVIDE INFORMATION ON HOBBIES. SPORTS. LICENSES, PUBLISHED MATERIALS OR DEVICES WHICH YOU MAY HAVE INVENTED.
SECTION VIII MILITARY SERVICE
CURRENT DRAFT STATUS
I. HAS YOUR SELECTIVE SERVICE CLASSIFICATION CHANGED?
^ YES E] NO
2. NEW CLASSIFICATION
3. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS
4. IF DEFERRED, GIVE REASON
MILITARY RESERVE, NATIONAL GUARD STATUS
CHECK RESERVE OR GUARD ORGANI? , ^ ARMY D MARINE CORPS ri COAST GUARD ^ NATIONAL GUARD
ZATION TO WHICH YOU BELONG El NAVY E] AIR FORCE ^ AIR NATIONAL GUARD
I. CURRENT RANK, GRADE OR RATE
2. DATE OF APPOINTMENT IN CURRENT RANK
3-EXPIRATION DATE OF CURRENT OBLIGATION
4. CHECK CURRENT RESERVE CATEGORY ^ READY RESERVE ^ STANDBY(active) STAND BY(inactive) RETIRED F1 DISCHARGED
5. MILITARY MOBILIZATION ASSIGNMENT
6. RESERVE UNIT TO WHICH ASSIGNED OR ATTACHED
MILITARY SCHOOLS COMPLETED (Extended .Active, Reserve Duty, or as Civilian)
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
DATE COMPLETED
" S I D E N T
AG E NC V? SP ONS O RED
SECTION IX PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS
NAME AND CHAPTER
Street
Cit
State
Countr
)
ADDRESS (Nu-ber
DATE OF MEMBERSHIP
,
,
,
y,
y
FROM
TO
2.
3-
SECTION X REMARKS
DATE
SIGNATURE OF EMPLOYEE
SE ET
(When filled In)
I
.moo
oml
n
~
^~o
0
~
C= cb C=
mm, cm
rx
--
C'
o
ti
om
rry
m
m
7U2
m
m
(-
z
m~
3
=
c
o
a
zm
r
m:z
D
n
Am
D A
3
I
-
ra
p
p
r
m
T
r-
0!
0
O
o
i ?
a 3
2 o
n
Ln
m
o
m
d?
n z
o~
0
im
0
) V
0 9
m
m~
z
m
y 0
z
0
A
? ~-d
<
0
Z
D
Z
0000
m
A
n
n
W
w
-Z.
M
V X X
X X >0 X
D
D
<
2
N
p E
1
O
?
<
0 .
~
a
El)
O
r
N
y
'
c
N m
y
m
DO
O.'* flU(.UI
.
~
m
Z:
t. C?; a'(4
. B
\
o
m
'-
\ > \ \ ....
o
L-
C: ii
Ol
PODO-
-
P
n
O
-ti
0
0 - UI+o
11
0
1
C-)
m
V o 0 0 0
z
O
mi
V F+F'Y
D
O i
f/1 0
.-.m
s~
i 0
P Ul UI VI
n
-C
co 0~
,
I!!
U-lDGP:
0
~c ca rcc
0 m
=
b0
Om
? n
n
9
a
o-e
6
o
z
z
11
ml
W
z
o
rao
~-.~
Cy7 Coo
rIIJ
b
z
om
;
o
n
U n
:
.
+ fil
?
?
c
,~
"
T
r
z
n
M
0
L
,
zm
x
-
m.Z
S
Mm
DA
t
A
n
- ',.
ra
o
r
o
m
0
0
6
? o
Z m
a
2 ?
? m
n
m
o
?
m
z
2
m
A o?
Z
C)
o
v
0
z
>
~m
V
i
Z
0 v
0 O
m
0
z
A
D
o 0 o c)
e
?
i
X X K
mxxx
p
n
o
mr
i
~
~
?
o
K
D
-. a
C
O
in
A'o
o
Z
N m
-
m;ar-t
C,_
D'
00 PP-
'
0
n
o
I
O
v a UI
\'\ \\?
O
3
f)
O_
Of'
m!
Vr(r
_
o
ms
n
f/1
x
-.m
All)
-
o u v
a g
PPt+N
'
O, v
QJUiCO!
O
_
O E C. C
+
AG
m
rp H I-~ la,.
rm
y
NSE Filled In)
SECTION III EDUCATION (copra)
HIGH SCHOOL
LAST HIGH SCHOOL ATTENDED
ADDRESS (City, State, Country)
YEARS ATTENDED (From-To)
GRADUATE
Q YES NO
COLLEGE OR UNIVERSITY STUDY
SUBJECT
YEARS ATTENDED
DEGREE
YEAR
NO. SEM / QTR.
NAME AND LOCATION OF COLLEGE OR UNIVERSITY
MAJOR
MINOR
FROM - - TO - -
RECEIVED
RECEIVED
HRS. (Specify)
2
15. IF A GRADUATE DEGREE HAS BEEN NOTED ABOVE WHICH REO'U ED SUBMISSION OF A WRITTEN THESIS, INDICATE THE TITLE OF THE THESIS AND BRIEFLY DESCRIBE ITS CONTENT,
tot:
t,
S
TRADE, COMMERCIAL AND SPECIALIZED SCHOOLS
NAME AND ADDRESS OF SCHOOL STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
2.
3.
OTHER NON-AGENCY EDUCATION OR TRAINING NOT INDICATED ABOVE
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
2.
4.
5.
AGENCY-SPONSORED EDUCATION
Specify which, if any, of the education shown in Section III was Agency sponsored.
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
FROM
TO
NO. OF MONTHS
2.
3.
4,
5.
2-
SECTION VII MILITARY SERVICE
CURRENT DRAFT STATUS
1.
ARE YOU REGISTERED FOR THE DRAFT? YES ^ NO
2. SELECTIVE SERVICE CLASSIFICATION
3. LOCAL SELECTIVE SERVICE BOARD NUMBER AND ADDRESS
4. IF DEFERRED, GIVE REASON
MILITARY SERVICE RECORD (Active Duty Only)
1. MILITARY ORGANIZATION (Army, Navy, etc. - specify)
2. BRANCH OR CORPS
3. DATES OF SERVICE (e.tended active duty)
FROMTO
4. STATUS (Regular, Reserve, etc. - specify)
5. RANK, GRADE OR RATE (at separation if past service)
6. SERIAL, SERVICE OR FILE NUMBER
7 CHECK TYPE OF [] HONORABLE DISCHARGE r7 RETIREMENT FOR SERVICE E] UNDUE HARDSHIPS
^
SEPARATION RELEASE TO INACTIVE DUTY F-1 RETIREMENT FOR COMBAT DISABILITY F7 OTHER (Specify)
^ RETIREMENT FOR AGE ^ RETIREMENT FOR PHYSICAL DISABILITY
8. BRIEF DESCRIPTION OF MILITARY DUTIES (record the duties and skills which best describe your work or function in the military service).
MILITARY RESERVE, NATIONAL GUARD STATUS
CHECK RESERVE OR GUARD ORGANI- ^ ARMY ^ MARINE CORPS ^ NATIONAL GUARD
ZATION TO WHICH YOU BELONG ^ COAST GUARD
^ NAVY ^ AIR FORCE ^ AIR NATIONAL GUARD
1. CURRENT RANK, GRADE OR RATE
2. DATE OF APPOINTMENT IN CURRENT RANK
3. EXPIRATION DATE OF CURRENT RESERVE OBLIGATION
4. CHECK CURRENT RESERVE CATEGORY READY RESERVE El STANDBY (active) STANDBY (inactive) RETIRED DISCHARGED
5. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES (record the duties and skills which best describe your work or function in the. military service),
6. IF YOU ARE CURRENTLY ASSIGNED TO A RESERVE OR NATIONAL GUARD TRAINING UNIT, IDENTIFY THE UNIT AND ITS ADDRESS.
MILITARY SCHOOLS COMPLETED (Active Duty, Reserve Status or as Civilian)
NAME AND ADDRESS OF SCHOOL
STUDY OR SPECIALIZATION
DATE COMPLETED
RESIDENT
CORRESPONDENCE
I
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
2.
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
3.
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
4
AGENCY-SPONSORED
RESIDENT
CORRESPONDENCE
5
AGENCY-SPONSORED I
7ET
-
S ndF017
(W en Filled In)
SECTION IV GEOGRAPHIC AREA KNOWLEDGE AND FOREIGN TRAVEL
KNOWLEDGE ACQUIRED BY - - CHECK (X)
NAME OF REGION
OR COUNTRY
TYPE OF SPECIALIZED
KNOWLEDGE
DATES OF TRAVEL
OR RESIDENCE
DATE & PLACE
OF STUDY
RE51-
DENCE
TRAVEL
STUDY
WORK
ASSIGN-
MENT
SECTION V TYPING AND STENOGRAPHIC SKILLS
1. TYPING (WPM)
2. SHORTHAND (WPM)
3. INDICATE SHORTHAND SYSTEM USED - - CHECK (X) APPROPRIATE ITEM:
GREGG SPEEDWRITING Q CTHERSTENOTYPE 0 SPECIFY:
4. INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (comptometer, mimeograph, cord punch, etc.)
SECTION VI SPECIAL QUALIFICATIONS
1. LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY IN EACH.
2. EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 4, SECTION V, LIST ANY SPECIAL SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND
MACHINES SUCH AS OPERATION OF RADIO TRANSMITTERS findicote CW speed, sending & receiving) OFFSET PRESS, TURRET LATHE, EDP AND OTHER SCIENTIFIC & PROFESSIONAL DEVICES.
3. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION SUCH AS PILOT, YES
ELECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL TECHNICIAN, PSYCHOLOGIST, PHYSICIAN, ETC.? 00. ^ NO
4. IF YOU HAVE ANSWERED 'YES" TO ITEM 3 ABOVE, INDICATE KIND OF LICENSE OR CERTIFICATION AND THE ISSUING STATE.
MUNICIPALITY, ETC. (Provide license registry number if known)
5. FIRST LICENSE/ CERTIFICATE (year of issue)
-6. LATEST LICENSE/ CERTIFICATE (year of issue)
7. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING
(non-fiction or scientific articles, general interest subjects, novels, short stories, etc.)
8. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED.
9. PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.
3-
SE~T
!5 -
3. DIRECTORATE-OFFICE OR DIVISION, ,BRANCH
5 ESiR'ET
(W Fiffed In)
1 INCLUSIVE DATES (From-To-by month & year)
2. LOCATION fCountry, City)
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
4. TITLE OF JOB
5. GRADES HELD IN JOB
6. DESCRIPTION OF DUTIES
1. INCLUSIVE DATES From- To- by month & year)
2. LOCATION (Country, City)
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
4. TITLE OF JOB
S. GRADES HELD IN JOB
6. DESCRIPTION OF DUTIES
1. INCLUSIVE DATES (From-To-by month & year)
2. LOCATION (Country, City)
3. DIRECTORATE-OFFICE OR DIVISION, BRANCH
4. TITLE OF JOB
5, GRADES HELD IN JOB
SECTION IX MARITAL STATUS
I. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, Annulled, Remarried) SPECIFY: t ? ! li-~e le / t'
2. NAME OF SPOUSE (LosJt (First) (Middle) (Mai en)
Ar -1)
3. DATE OF BIRTH
4. PLACE OF BBIIRRT (City, Se, County) '1 r
5. OCCUPATION
6. PRESENT EMPLOYER
7. CITIZENSHIP
ti .S
8. FORMER CITIZENSHIP(S) COUNTRY(IES)
9. DATE U. S. CITIZENSHIP ACQUIRED
SECTION X DEPENDENT CHILDREN AND DEPENDENTS OTHER THAN SPOUSE
NAME
RELATIONSHIP
DATE AND PLACE OF BIRTH
CITIZENSHIP
PERMANENT ADDRESS
S
J*G5
1~" c .
t'3
SECTION XI PROFESSIONAL SOCIETIES AND OTHER ORGANIZATIONS
DATE OF MEMBERSHIP
NAME AND CHAPTER
ADDRESS (Number, Street, City, State, Country)
FROM
TO
DATE
//
612
SIGNATURE OF EMPLOYEE
7,