FORM TO BE FILLED IN BY APPLICANT
1- Name and address, and age, and parentsí names.
2- Date of enlistment
3- Name, Battalion and Company, ( or ship or ships) on which you served.
4- Date of leaving Newfoundland for Active Service.
5- Have you been employed whilst with the Colours? If so, in what capacity?
6- Date of return
7- Date and reason for discharge form service.
8- Occupation and experience in civil life before enlistment
9- Name address of your last or any other employer before enlistment, etc., the nature of employment and how long you were employed.
10- Have you made any, and if so, what efforts to obtain employment?
11- What, if any, work have you been doing since your discharge?
12- State what special qualifications you have for employment in civil life, and the kind and locality of work you wish to obtain.
N.B.- Where possible this form should be filled in and signed in the presence of a Clergyman, Magistrate, Justice of the Peace, School Teacher, or other prominent person in the neighborhood of the applicant.
Source: The Rooms, Provincial Archives, St. John's, NL