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U.S. MARINE CORPS REPORT OF SEPARATION

NAVMC 78-PD

Last Name: Francis

Suffix:

First Name: Joseph

Middle Names: Peter

Rank: Pfc

Pay Grade: 6

Serial Number: 1007352

Permanent Address: 915 10th St N E

Race:

Sex:

Citizen:

Date of Birth:

Address for Employment:

Married:

No. of Dep.:

Place of Birth:

RECORD OF MARINE CORPS SERVICE

Selective Service Data

Registered:

Address at Entry into Service:

Sel. Ser. Bd. No.:

Sel. Ser. Bd. County & State:

Means of Entry (1):

Means of Entry (2):

Place of Entry into Active Service:

Date of Entry:

Component REG.:

Component RES.:

Pension Claim Filed:

Place of Separation:

Date of Separation:

Org. at Separation:

Type of Discharge:

Foreign/Sea Service Years:

Foreign/Sea Service Months:

Foreign/Sea Service Days:

Military Specialties :

Service Schools Attended:

Service School Courses:

Service School Weeks:

Principal Military Duty and No.:

Notes:

EMPLOYMENT AND NON-SERVICE EDUCATIONAL DATA

(1) Civilian Occupation:

(1) Civilian Occupation No.:

(1) Civilian Occupation No. Yrs.:

(1) Civilian Occupation Last Employed Date:

(1) Civilian Occupation Summary:

(2) Civilian Occupation:

(2) Civilian Occupation No.:

(2) Civilian Occupation No. Yrs.:

(2) Civilian Occupation Last Employed Date:

Last Employer Name:

Last Employer Address:

Date Left Last Employer:

Job Aid Desired:

Non-Service Education

Grammar Years:

High School Years:

College Years:

Degree:

Major Courses:

Trade Courses:

Courses of Greatest Interest:

Last School Attended:

PREFERENCES

Preference for Additional Training :

Job Preference:

Job Preference Reason:

Locality Preference:

Locality Preference Reason:

Name and Rank of Discharging Officer:

Date Signed by Discharged Person: