KIBEI SURVEY LAUNCHED, GIVING THEM ASSISTANCE; CHAPTER AIDS

In the interest of the Kibei, the National Headquarters of the Japanese American Citizens League is undertaking a survey of those people. Each chapter is asked to assist. The survey is entirely voluntary on the part of kibei. They may fill out the following questionaire [questionnaire] and take it to Seattle JACL, headquarters, 517 Main Street. Blanks also will be available at chapter headquarters.

SPONSORED BY THE JAPANESE AMERICAN CITIZENS LEAGUE IN THE INTERESTS OF AMERICANISM

1. Name: (Last) (Japanese) (American)
2. Home address: (St. or RFD) (City or County) (State)
3. Business or Occupation
4. Name of Business Firm
5. Business Address
6. Business Phone
7. Home Phone
8. Age Today
9. Age when last left for Japan
10. Age when last returned from Japan
11. Date when last returned from Japan
12. Total number of years spent in Japan
13. Total number of trips made to Japan
14. Purpose of trips to Japan
15. Education (in U.S.A.), Years, Degree or Grade
16. Education (in Japan), Years, Degree or Grade
17. Religion
18. Military Experience: (in Japan), Years, Rank, Branch, Where
20. Selective Service Order No., Classification, Board No.
21. Hobbies
22. Organization membership in past five years (church, Japanese associations, Kenjinkais, Seinenkais, etc. Whether now disbanded or not. If you were an officer in any of them, state the office held and the year, after the name of the organization)
23. Dual Citizen. Yes, No, Don't Know

I, THE UNDERSIGNED, do hereby state that the above given statements are true and correct.

(Signature)

ATTEST: Chapter, By