General survey for evacuee resettlement
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GENERAL SURVEY FOR BVACUEE
RESETTLEMENT
Inland Farm Cooperative
1530 Buchanan Street
San Francisco, California
1. HEAD OF FAMILY No. in Family
`Last "~ Tirst
2. ADDRESS
Route or Street No. City or Town
3. NAMES OF OTHERS IN FAMILY: AGE
M or FEMALE
4. Those over 18 years of age will give their qualifications and abilities
so that talents, special skills, experiences, and occupation can he
determined in the project.
`NAMES OCCUPATI ON
SPECIAL SKILLS__
TRAINING OR EDUCATION
High School College Major
ACTUAL EXPERIENCE : es
What type of work: No. of years
OTHER QUALIFICATIONS 4
oo
_ ASLM BQUIPMENT IN POSSESSION
C4 OTHER USEFUL EQUIPMENTS
* This survey will be used to determine the number of homes, hospitals,
schools, acreage of farms, and etc. that will be needed in this COOP
ERATIVE Project.
Kindly attach a sheet of paper in giving further information if
necessary, but be sure to prefix the correct number of the
question for each answer. Thank you.
* IMPORTANT; Notify above address of any change of your address or if
you have made other plans, let us know. (this is most im
portant for this survey to be effective.)
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