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| 1. What is your date of birth?
*(MM/DD/YYYY)
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| 2. Current marital status(please
select one answer): |
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Married/Domestic Partner |
Widowed |
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Divorced |
Never Married |
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Separated |
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| 3. How many people, including
yourself*, live in your household?
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| (*If you live alone, please skip
to question 5.) |
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| 4. Please provide the age
and relationship, to you, of the persons in your household: |
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| 5.a. What is your current
occupation? (If retired or umemployed, please state.) |
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| 5.b. Number of years you
have been in your current occupation/retired/unemployed: |
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| 6. Have you ever been employed
as an airline flight attendant?
Yes
No |
| (*If you answer NO, please go
to question 8.) |
| a. Dates worked as a
FULL-TIME flight attendant (MM/YYYY):
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to
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| b. Dates worked as a
PART-TIME flight attendant (MM/YYYY):
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to
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| c. Section worked:
Smoking
Non-smoking
Both
Not separated |
| d. Cabin worked:
First
Business
Coach |
| e. Majority of routes:
Domestic (U.S.)
International |
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| 7. Please list other former
occupations and approximate dates of employment: |
(List only occupations of at
least 2 years duration; list in broad categories such
as, "business executive", "health care worker", "bar/restaurant
employee", "student")
Start with your most recent occupation and work back. |
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