[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
[The questionnaire form for information concerning the volunteers for one-year teacher training classes related to year 1342 (1963)]
In reply to number ----- and subject ---- please refer.
Information concerning the volunteers for one-year teacher training classes
- Name …–Surname
- Birth certificate number
- Place of issue
- Date and place of birth
- In which senior high school did you complete grade six [year 12]?
- Your field of diploma [year 12]
- Date of graduation
- Name and occupation of father
- Name and occupation of mother
- Do you have a spouse?
- If you do, provide the name and occupation of your spouse.
- Number of children
- In which university have you been studying?
- What is your religion?
- Who is the last prophet of God?
- Which is the last heavenly book of God?
- In the absence of the Imam of the Period (Peace be upon him), Shias follow the more learned religious authority. What do you do?
- Complete home address and house number
- Phone number
- Sample of signature
- If the home address or any other details in this declaration change, I am committed to immediately inform the institute office.