Divorced? (If not, why not?)

Full name and address of last employer and occupation.

Names of all editors by whom employed, with bill of particulars

giving times and places.

Cause of leaving (in each case).

Names of “high-class publications referred to who will endorse

the applicant as a reliable, industrious and competent person

of marked literary ability.”

_Witnesses_: ____X____ _Mark here._

_________

_________

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