ADDITIONAL INFORMATION What was your attitude toward military service in general and toward your call in particular? What were the mental and physical Show moreADDITIONAL INFORMATION What was your attitude toward military service in general and toward your call in particular? What were the mental and physical effects of your army experience on yourself? What elements of your college life and work were most valuable to you in service? What is your present feeling regarding universal military training, etc.? If you took part in the fighting, what impressions were made upon you by this experience? Photographs—If possible, enclose one taken before entering the service and one taken afterwards in uniform, both signed and dated—also interesting snapshots taken in camps or overseas. Additional data, Signed at /V~/)L on 9'3: /7L u... I (place) (date) M an. 6% am»— Aw. (full name) (rank) (branch of service) The information contained in this record, unless otherwise indicated, was obtained from the following persons or SOUI‘CESI NOTE—Write additional information on separate sheet of same size. Show less
a ‘- aw ‘ ' flwmxmwwm WW: 7" v. WAR RECORD W Entered service on i ....... .. , at (date) (place) (rank) in the 7 , . ,V section of or in the Show morea ‘- aw ‘ ' flwmxmwwm WW: 7" v. WAR RECORD W Entered service on i ....... .. , at (date) (place) (rank) in the 7 , . ,V section of or in the . . . . . . . 7 . . . . V . , V V V _ _. (name civilian organization, such as Red Cross, Y. M. C. A., etc.) Assigned originally to VVVVVVVV to (company) (regiment) (division) (or) at (ship) (place) Trained or stationed before going to Europe : — School, camp, station, ship From (date) to (date) Transferred to : — Company Regiment Division - Ship Date New Location Promoted : —- From (rank) to (rank) Date Embarked from on (port) ' (ship) and arrived at (date) (foreign port) (date) Proceeded from to ...... _. (date) From to (date) From to - (date) Trained or stationed abroad:— Country Place From (date) to (date) NOTE—Write additional information on separate sheet of same size. Show less
WAR RECORD First went into actiOn (date) (place) Participated in the following engagements, and in what capacity Cited, decorated, or otherwise Show moreWAR RECORD First went into actiOn (date) (place) Participated in the following engagements, and in what capacity Cited, decorated, or otherwise honored for distinguished services (give circumstantial accounts of exploits includ- ing dates and places where performed, also by Whom and in what manner the honors were bestowed): Killed in action, killed by accident, died of wounds, died of disease, wounded, gassed, shell—shocked, taken prisoner: Nature of casualty Place Date Under medical care:—— Name of hospital Location From (date) to (date) Permanently disabled (through loss of limb, eyesight, etc.) (specify disability) Arrived at on ............. .. (American port) (Ship) (date) (from) Located at . _ _ _ , , , _ _ . .. engaged in till (name place in U. S.) (kind of duty) (date) Located at A , _ _ , , 7 V . . . . ..engaged in till (name place in U. S.) (kind Of dutY) (date) Discharged from service at (place) (date) as a . (rank) (unit) RETURN TO CIVIL LIFE t X occupation after the war ........ _____________________ ._ g W / W If a Change of occupation was occasioned by reason of disability acquired in the service, discribe the process of re-education and readjustment, and indicate the agencies or individuals chiefly instrumental in furnishing the new occupation. NOTE—Write additional information on separate sheet of same size. Show less
Note—This document is to be bound and preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by Show moreNote—This document is to be bound and preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by typewriter. Leave blank space where nothing is to be entered. Mealvyan Hniurmitg SERVICE. RECORD Compiled by The Wesleyan Alumni Council, to be printed in book form, originals to be filed in The Wesleyan Library as a permanent memorial of the deeds of Wesleyan men in the service of the United States or Allied governments during the World War. This questionnaire should be completed so far as possible and sent at once, with photographs and additional notes and letters, to The Wesleyan Alumni Council, Middletown, Conn. Name in full m M A (family name) (first name) (middle names) Date of birth 6 [ff] (month) (day) (year) I Place of birth 6 4494014040 (8mm) (county) (state) / (country) Name of father W Birthplace W jam 8 a (country) Maiden name of mother “KW Birthplace QM (country) Relatives who are Wesleyan men, and class .............................................. ..................................... __________________________________________________________________________ ., Prepared for college at 5 74% if (preparatory school) Entered college 4905. ; graduated (or left) I 94 W? ) (date) (date) / q l , Fraternity £0"! ; Class Societies 54:19.1 Z6 C t C W W W Academic degrees 6 o S ' W '1 KW (degree) (instituém) (date) m 1, u 1/ /7/3 VI - 3 n " ’7 l 7/ 6 Honors and distinctions after graduation Mvfl' AW 17/]? Married..%mto 7W of 6 on Jaw? /?/r (maiden name) (date) Children w (Lu/w born SO;AX//V. /7/£ V I I (name) (date) 96 A4 a gu/o . A. no (/9144 13 1,949 Occupation before entry into service/(“‘7 Wow ’0) var/(find? ; employer W ’3 63/1,. 4,; W 51 mm; a. Residence before entry into the service 5/ // ' (street number) (town) (county) Present address / 7 7% W fin-H , (street number) (town) 4county) (state) Permanent address g M a; W . NOTE—Write additional information on separate sheet of same size. Show less
ADDITIONAL INFORMATION What was your attitude toward military service in general and toward your call in particular? ................................. Show moreADDITIONAL INFORMATION What was your attitude toward military service in general and toward your call in particular? ........................................................ .. _____ _ , ._ ._ .. .i _ :V __ is a Wldt is your present feeling regarding universal military trainingjjetc. ? dag/Joy +++++++ n/am y“ ’ If you took part in the fighting, what impressions were made upon you by this experience? Photographs—If possible, enclose one taken before entering the service and one taken afterwards in uniform, both signed and dated—also interesting snapshots taken in camps or overseas, Signed at .... (place) (date) 4:" ' fl . , A 3 [/F 1 I j / K 15% 2/121, xvi" ‘ i417 (fun mama (blflch of service) . . . . . . . . 6?". . The 1nformation contained 1n thlS record, unless otherw1se indicated, was obtained from the follow1ng persons 01‘ SOUI‘CES ' NOTE—Write additional information on separate sheet of same size. Show less
WAR RECORD j .................. .. .. (date) (place) ,asn (rank) in the Wan/3w , I ’5? section of (infantry, artillery, aviation, etc.) the ____ ._ Show moreWAR RECORD j .................. .. .. (date) (place) ,asn (rank) in the Wan/3w , I ’5? section of (infantry, artillery, aviation, etc.) the ____ ._ (regular Army, National Guard. Home Guard, National ArWavy, Naval Reserve, Marine Corps, or Allied Army) Entered service on ............... a or in the ..... (name civilian organization, such as Red Cross, . M. C. A., etc.) .5 Assigned originally to {7 . ‘ (company) (regimenty/ (division) (or) .. .. .. .. (ship) Trained or stationed before going to Europe: —- School, camp, station, ship From (date) Transferred to: — Company Regiment Division Ship Date New Location A“) Einbarked on..,__ _/, V I / '(iso'éi) ‘ """""""""" " fix; I /r and arrivedat 5.4a /J'W (date) Proceeded from W From W I From ........... , 94 MIC} Trained or stationed abroad:— Country Place I From (date) to (date) ..... __ .... . .. . OTE—_Write additional information on separa sheet of same size. gamma Mflaaaa. m m’Q/L’ M i , ' j 47 , flaw, WM,V-av @deo'IvflnZy/avéq W [MW 437 Show less
'A I, A\4»~ " H p - ‘wt‘r'4‘ l 67‘!“ 1‘; 5‘“ O "Hi i . Wu *5." 3 fin“; ‘ ti ' . r I _ I «Mi 7 ‘pa‘ .. : .xq "" Show more'A I, A\4»~ " H p - ‘wt‘r'4‘ l 67‘!“ 1‘; 5‘“ O "Hi i . Wu *5." 3 fin“; ‘ ti ' . r I _ I «Mi 7 ‘pa‘ .. : .xq ""nc. ..,‘- Show less
WAR RECORD First went into action (date) (place) Participated in the following engagements, and in what capacity .............. ._ ‘ AAA WW .......... Show moreWAR RECORD First went into action (date) (place) Participated in the following engagements, and in what capacity .............. ._ ‘ AAA WW ........... . . . Cited, decorated, or otherwise honored for distinguished services (give circumstantial accounts of exploits, includ- ing dates and places where performed, also by whom and in what manner the honors were bestowed): W Killed in action, killed by accident, died of wounds, died of disease, wounded, gassed, shell—shocked, taken prisoner: Nature of casualty Place Date Under medical care: — Name of hospital Location From (date) to (date) W Permanently disabled (through loss of limb, eyesight, etc.) (specify disability) .................................... ..‘ ................... .., ............ _________________ , Arrived at... . (American I ort) (ship) ate) Located ath .. .. .. ' » (name place in U. S.) (kind of duty) ’ Located ____ till...“ (kind of duty) I (date) Discharged from service at i - (211-19 ‘52 6 / / I date) / as a ............... _, (unit) RETURN TO CIVIL LIFE a: 5‘ ' \ ' \ ,t Aim/j Occupation after the war . - 1 I " If a change of occupation was occasioned by reason of disability acquired in the service, describe the process of re-education and readjustment, and indicate the agencies or individuals chiefly instrumental in furnishing the new occupation. _ [NOTE—‘Write additional information on separate sheet of same size. Show less
Note—This document is to be bound and preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by Show moreNote—This document is to be bound and preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by typewriter. Leave blank space where nothing is to be entered. ‘ Mealvgan Huinpraitg SERVICE RECORD Compiled by The Wesleyan Alumni Council, to be printed in book form, originals to be filed in The Wesleyan Library as a permanent memorial of the deeds of Wesleyan men in the service of the United States or Allied governments during the World War. This questionnaire should be completed so far as possible and sent at once, with photographs and additional notes and letters, to The Wesleyan Alumni Council, Middletown, Conn. Name in full Classe/Z/‘f (family name) (first name) (middle names) Date of birth V W gig? /£ ? t3 (mont ) (day) i/(year) ‘ Place of birth /. , , , , VVVV ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ........ .. (town) (country) Name of father rrrrrrrrrrrrrrrrrrrr , . (country) Maiden name of mothenOZ ., . I (country) Relatives who are Wesleyan men, and class 7441;; ...... .. Prepared for college at VVVVVVVVVVVVVVVVVV . w _V i ' Entered college /,?/l/ .......... .. ; graduated (or left)" , V, .. . ..... 77 ,,,,,,,,,,,, ._ / (date) ‘ (date) Fraternity .................................... / V ............. u . ..... rrrrrrrrrrrrrrrrrrrrrrrrrrrr ._ ; Class Societies 1 Academic degrees _________________________ .... ._,, .... .. V .V a N ,,,,,,,, t . (degree) (institution) (date) Honorsand distinctions after graduation Married .......................... .. to - of on a (maiden name) , (date) Children born (name) (date) Occupation before entry into service ........................... ................... V. . ,,,,,,,, ,, ; employer”... .i .. . . .. .. a , Residence before entry into the service (town) (strem) ' Ocounty) i Present address I (streetv umber) (town) (CW (state) Permanent address J 1‘? 66M] . ' My) I V NOTE%ite additional i mation on separate she fit same size. ,5” ' ¢ Show less
ADDITIONAL INFORMATION _ I? ' What was your attitude toward military service in general and toward your call in particular? v ‘ " I j I ‘ l Show moreADDITIONAL INFORMATION _ I? ' What was your attitude toward military service in general and toward your call in particular? v ‘ " I j I ‘ l “1.1.;- a b " f x 3.4» A 4» $1“! V . Mp 6‘ «db .s i, J i Q. J ' «2—- V C I~ :1 — ~/ 1 K *- LD ~ , . _ . . _ _ _ _ . V V V V _ V V V .V f . . 1’ {14 m: ’r“. I What were the mental and physical effects of your army experience on yourself? c ‘ «0" f .............. _ ,» '- ‘i ’ ' ‘ f ‘ j’ 4, ' ‘ m If r v Vi”? I , A, V'ZK‘" r” i “7"” ' L 1“" J“- i i‘ '"f I; A " ' R b ‘1 ~A~‘3“ 9“" " ~ 1. ‘ IL, ’ i , i r ,1 - ' i I ~ .4 vi" 1y“ 1- Km: . , i «19"..- V:, 'i 1. 9 "‘- f In... I v 2, " ,v" - - V1; p» " n I r I» » L“; What elements of your college life and work were most valuable to you in service? ,,,,,,,,, :96?" v-L " " ' ‘— C‘ I What is your present feeling regarding universal military training, etc. H4??? ,,,, ........... as” " “A “‘9‘ ' V r i— , ; ~ ‘ it A . "JML ' _ {—- {i L“ P‘Ef“ L... Xx s -‘s. \r A. J L If you took part in the fighting, what impressions were made upon you by this experience? "i ‘ " '“ “I” “C x Iv ‘ , « "_ I l ‘ ,,,,,, ,L‘viii’ffrfig—a i" “If. "T ,1"i,,,‘,:fr’;, ' faker“ .353 n “A "l A ' ‘ " ' £7 Photographs—If possible, enclose one taken before entering the service and one taken afterwards in uniform, both signed and dated—also interesting snapshots taken in camps or overseas, Additional data, - .. i u“ ’ _ -—- Sl I1€d at ...... .. J ‘ ' "‘7 ‘ *v on -- ~ . 1—- I I (.1 I g I (place) (date) / ‘ ' I f . ' .. _______________ H “ z r, .2' t - “ r . 77 ~42“ L L . \ ‘ N _ v7 (full name) (rank) (branch of service) The information contained in this record, unless otherwise indicated, was obtained from the following persons 01‘ sources ' NOTE—Write additional information on separate sheet of same size. Show less
WAR RECORD Entered serv1ce 011W. at ------------ """"""""""""""""" Show moreWAR RECORD Entered serv1ce 011W. at ------------ """"""""""""""""""""""""""" """('"lqce) (date) p ( as a ...... .... V ....... 0" ......... “*- . . . L a" ' ' VK ' Kl- ......... .. (rank) - C: 1L” Jam" ~ ' 111 _______________________________________________ _ _______ _______________________________________________________________ ............... """"""""""""""""""""""""""""""""""""""""""""""""""""""""""""""" """"""""""""""""" " 'i (infantry, artillery, aviation, etc.) the w ............................................................................................................................................................................................................................... u or n H I. H V H V ______________________________________________________________________________________________________________________________________________________________________________ ' ‘ ' ‘ ' ' ' ‘ ' ' ' ‘ ' ' ' ' ' ‘ ‘ ' ' ' ' ’ ' ' ' ' ‘ ' ‘ ' ' ' ' ' ' ' ' ‘ ' ‘ ' ' ' ' ' ' ' ' ' ' ' - ‘ ‘ ' ' - - - - - - r ~ - » - - - -- ,,- cf ._ ,. \' W Assigned originally to ....................................................... -------------------------------------- --, ----------------------------------- ‘ - ' - ‘ ‘ ' ' ' ' ' ' ' ' ' ‘ ' ' ' ' ' - ~ - - - 4 ' - - - - 4 ‘- 91”)sz fl (regiment) (if (dIVISIOn) \. or, ____________________________________________________________________________________________________________________________________ "at _____________ _; ________________ ....................................... ................ a, ( ) (ship) (place) Trained or stationed before going to Europe: — r 7 if “firg From (date) to (date) ‘ 31—1. (an ngx, aslvuqn School, camp, station, ship Transferred to: ——— Regiment Compan Ship Date New Location Promoted: — From (rank) 1 M to (rank) Date /- ‘ ft. I . I“ _ r pewww mam «'4 I7 Vvyi ‘ _-3(m.¢\ — , \ fl ‘ L] ' (q Ig EmbarkecL from EM . v on 3? ~‘ LIL— v S . '5‘ . ;.__ A 7:: I (port) (ship) .................................................. .. and arrived at ~ (date) (foreign port) (date) . to twin. M 1qu 1% _ . (date) i - f \ From . V VVVVVVVVVVVVVVVVVVVVVVVVVVV _. to .. \‘r‘w‘d" l$ F (date) Proceeded from , From . , to (date) Trained or stationed abroad:— Country Place From (date) to (date) u _ V\{ (\v - i “ a . v . _C_ ‘ — x ‘ r _ i ‘ (‘M_ H A‘ MW trim—Wauw’fiig K. M ‘ K 0.4»; ¢L_ ,{H_« A - NOTE—Write additional information on separate sheet of same size. Show less
WAR RECORD First went into action (date) (place) W 0 <3 1,9... éxmw—H—M mil-A4 Participated in the following engagements, and in what capacity , w Show moreWAR RECORD First went into action (date) (place) W 0 <3 1,9... éxmw—H—M mil-A4 Participated in the following engagements, and in what capacity , w V ‘ AL'- _ ‘ ' f q" —“ ‘__. _ ‘ , ........................ .. 1" K’Q“ (TR I (rle f L/ LN ‘k/i “vex/{k «I (f, I. Cited, decorated, or otherwise honored for distinguished services (give circumstantial accounts of exploits, includ- ing dates and places where performed, also by whom and in what manner the honors were bestowed): Killed in action, killed by accident, died of wounds, died of disease, wounded, gassed, shell-shocked, taken prisoner: Nature of casualty Place Date Under medical care: — Name of hospital Location From (date) to (date) Permanently disabled (through loss of limb, eyesight, etc.) 'v C i, I (A & :fib. (specify disability) . i » ‘- C ‘ ' ‘ .a ‘ f Arrived 41W,"3'7refrion........lL’L ' v ‘ ‘3 ’ "“‘ ‘ I I it” if, I b I i 1 [q Allan (American port) (hip) s (date) - g V v ' (from) 7 f ‘ ‘ r . ‘ -> -\ Located at M 1 £- 4 v - engaged in], .................................................... ....... . .1. ....... ._till owl—Au La i l {1 ‘9 (name place in U. S.) ( ind Of duty) (date) Located at ___________________________________________ engaged in till (name place i1} U. S.) fig “ ‘ (kind of duty) 4 (date) . . ’ 4,? ‘1' ‘ 4 V « Discharged from serv1ce at ‘Q “Mi .... (ifLMA-‘L- Di ’ “l ' ‘ (place) i ‘ (date) I. - A, n "‘- 3,», as 3,, wt, ( Lew) _______________________________________________________________________________ _ (A6. A K .+. I q ,(rank) (unit) - RETURN TO CIVIL LIFE - _ , ‘ f H ,4: Iv; q . " ~ , ..A 'v *7» aka“ L V“ J~w~ _ ' Occupation after the Vvar ,,,, ___________________________________ 7 i“ . 7 ’l 7777 N '6 ‘ it, If a change of occupation was occasioned by reason of disability acquired in the serVice, describe the process of re-education and readjustment, and indicate the agencies or individuals chiefly instrumental in furnishing the new occupation. NOTE—Write additional information on separate sheet of same size. Show less
Note—This document is to be bound ayi’d preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by Show moreNote—This document is to be bound ayi’d preserved as a permanent record. Please fill it out completely, accurately, and neatly, either in ink or by typewriter. Leave blank space where nothing is to be entered. Mailman Huiurraitg SERVICE RECORD Compiled by The Wesleyan Alumni Council, to be printed in book form, originals to be filed in The Wesleyan Library as a permanent memorial of the deeds of Wesleyan men in the service of the United States or Allied governments during the World War. This questionnaire should be completed so far as possible and sent at once, with photographs and additional notes and letters, to The Wesleyan Alumni Council, Middletown, Conn. Name in full “ch/m— W W Class.....l_iolm U... Q family name) (first name) (middle names) Date of birth W I l g 8/ C1 (month) (day) (year) Place of birth W Dam/(L L46 k- VL— , ...... _. (town) (county) (state) . (country) I Name of father Q 7 i) Birthplace ,, V. ,, ' S V , _ (country) Maiden name of mother E ' ,,,,,,, ,.‘ Mk Birthplace UL - S . (country) Relatives who are Wesleyan men and class W \U ~ 2 ,g j, 'qg ,‘ '0' 3 g: l Prepared for college at , EM (preparaer school) Entered collegew. - ‘q o 7 ; graduated (or—leiit). ML ‘4 I l P “ (date) . Fraternity 54-— W ; Class Societiesjfxfj . ,, Academic degrees, ' V _ . 1 . U (degree) (institution) (date) LL-H WA.— 1mg Honors and distinctions after graduation“, 7 . . . 7 VVVV ,. WP ‘f Married to of » on“. (maiden name) Children _____________ .. . born (name) (date) Occupation before entry into service ,. V I A ,, employer J V" LU ' ' {I ~‘2.d‘ ‘ .3, w war; «a: it NMQ/L-LL, Re51dence before entry into the serv1ce N 'U ,A A! (street number (town) /‘ (county) _ ‘\ Present address 0 '5 lg LML ’ a L (.¥M_:\aw t" l (stre number) (town) (county) ‘ ' (state) - W i . \ f a Permanent addressfir 2 ° " ‘ W v‘ m : 1- “M ' NOTE—Write additional information on separate sheet of same size. , . . . . . . . . .. _ , Show less
ADDHHONALINFORMATKDQ \Vhat was your attitude toward military service in general and toward your call in particular? Deemed it a privilege to serve my Show moreADDHHONALINFORMATKDQ \Vhat was your attitude toward military service in general and toward your call in particular? Deemed it a privilege to serve my country in time of Emergeno' all-9‘ meremre avai~lessra381f Of first. Opportunity ____ "mienter semiae. What were the mental and physical effects of your army experience on yourseit ? i. _Whatever mental or physical ability I now possess is due in a considerable degree to the experience I have had as a member of the Military Establishment. What elements of your college life and work were most valuable to you in service?. ............... A. It is hard to measure an experience of eignt mu‘nine years standing. Undoubtedly lessons in concentration, compatability, leadership, and loyalty have played a large part. What is your present feeling regarding universal military training, etc. .....Inasmuch...a.swLemma VVVV $3.131: VVVVVVVVVVVVVVVVVVVVVV .. _of_tne General Staff, Iddo not feel at liberty to discuss this question. Photographs—If possible, enclose one taken before entering the service and one taken afterwards in uniform, both signed and dated—also interesting snapshots taken in camps or overseas, Additional data, Signed at ...... ...................................... k on M ’1‘: /§. /? I (place) (date) ___________________________________________ fl M We M—«q v. ' V (rank) ,/(branch of service) / he information con ained in this record, unless otherwise indicated, was obtained from the following persons 01‘ sources ' NOTE—Write additional information on separate sheet of same size. Show less
WAR RECORD Aug 24, 1917 :” Fort Niagara, New York. (date) (place) Entered service on ............................... __ as a....._.Q_£_fric Show moreWAR RECORD Aug 24, 1917 :” Fort Niagara, New York. (date) (place) Entered service on ............................... __ as a....._.Q_£_fric_ermcandiaate ,,,,,,,,,, ,, , (rank) in the Field Artillery ' section of (infantry, artillery, aviation, etc.) the” ._ _. .. . National Arm ............. .. (regular Army, National Guard, Home Guard, National Army, Navy, Naval Reserve, Marine Corps, or Allied Army) or in the ,,,,,,,,,,,,,,,,,,,,,, ,, (name civilian organization, such as Red Cross, Y. M. C. A., etc.) Assigned originally to ........... ..2nd_..B.at.tery .......................... 2nd..,.,},;ézagvisri.o.nal.unmrainingWRegiment , (company) (regiment) (division) (or) ' a t (ship) (place) ' Trained or stationed before going to Europe: — Fort Niagara School, camp, station, ship From (date) ‘ to (date) rrrrrrrrrrrrrrr "Frgytfliagara Aug 24.1917 Nov 27, 1917 . Camp Upton N Dec 15,1917 May 1 , 1918 _____ __ V a Washington,_D C May 1,1918 Still on duty Oct - 1919 Transferred to: —— Company . Regiment Division Ship Date New Location I» Promoted: —— Inmnoamd Officer Candidate tooamg Captain F A DateNov 27, 1917 Captain F A Major F A July 14,1918 """""""""""""""""""""" "Major, F A ' Lt Colonel F A Juns"”"26;1'919"”““"“ Embarked from ...................... .7 . a . , ' ,, . a . on . . . . . . , . , . . _ . . _ _ . . a _ , . , . . _ __ (port) (ship) and arrived at (date) (foreign port) (date) Proceeded from to (date) From to' . (date) From to (date) Trained or stationed abroad:—— Country Place From (date) ' to (date) NOTE—~Write additional information on separate sheet of same size. Show less