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Salient. Victoria University Student Newspaper. Vol 35 no. 8. 27 April 1972

Confidential

Confidential

1.How long have you known the candidate?
2.Are you related to the candidate? If so, please describe the relationship.
3.Have you known the candidate as:
(a)a friend?
(b)an aquaintance?
(c)an employee?
4.If as an employee -
(a)over what period was the candidate employed by you?
(b)why did the candidate leave your employ?
5.As far as you know is the candidate -
(a)Reliable?
(b)Sober?
(c)Conscientious?
(d)Of good character?
(e)Discreet?
(f)Free from any significant history of mental or physical disability?
(g)Free from undue financial pressure?
6.As far as you know -
(a)Is the candidate associated in any way with a Communist Party or with any body that is looked upon with favour by Communist Parties, e.g. in New Zealand, the New Zealand Peace Council, the NZ-USSR Society, the Chinese Cultural Association, the New Zealand China Society (or The China Friendship Society)?
(b)Is the candidate associated in any way with a Fascist organisation?
(c)Has the candidate had association in the past with any of the parties or societies named in (a) and (b)
7.If there are any other comments you would like to make, bearing on the candidate's character and reliability, please make them here or on a separate, sheet.
8.Can you give me the name and address of another person who can assist in this enquiry?
9.Would you prefer that a member of this Service should call and discuss this matter with you?
Signature: ................... Date: ................... 20,000/10/64—94145 W