[Illegible annotation in top right corner.]

[Stamped in blue ink 'V.C.R., 5th MILITARY DIST., [district] WESTERN AUSTRALIA.' With handwritten reference number '241/5/43' written inside stamp.]

C.M. Form A. 22 (Revised 1.7.14.)

[Header in black ink: 'AUSTRALIAN MILITARY FORCES', with image of Australian coat of arms.]

[Heading:] Application for a Commission in the [handwritten] Aus Imp Exped Forces [Australian Imperial Expeditionary Forces. Handwritten ends.]

[The following information is presented in a table, the first column is labelled 'No.' [Number], the second column is labelled 'Particulars'. The questions are typed and all answers are handwritten.]

1. Surname

Other names (in full)

(To be in block letters)  

[Handwritten response:] Throssell

Hugo Vivian Hope

[Handwritten large red tick, and letters 'C of E'.]

[Stamped in purple ink 'DEFENCE A.I.F.' with handwritten reference number 100 – 1 – 223.]

2. Educational Qualifications

(Certificate to be attached for notation at district headquarters.)              

[Handwritten response:] 7 years a student at Prince Alfred College Adelaide SA

3. Military Qualifications (previous Military Service, if any, to be stated)

(Attention is directed to third sub-pars of C.M. Regulations 66.)

Present rank and corps to be stated.      

[Handwritten response:] 6 1/2 years as a Trooper in 18th ALH [Australian Light Horse.]

4 months as Sergeant in 10th ALH[.]

4. Date on which applicant qualified at a competitive examination for first appointment as 2nd Lieutenant

(U.T. Regulation 132)

[No response.]

5. Present Civil Employment

[Handwritten response:] Farmer

6. Date of Birth, and Age.

(Certificate of Birth or Statutory Declaration to be attached for notation at District Headquarters.)            

[Handwritten response under typed heading 'Date of Birth':] 27th October 1884  

[Response under typed heading 'Age':] 30 Years. 3 1/2 Months.

7. If a British Subject of a Naturalised British Subject

(In the case of the latter, date and place of Naturalisation to be stated.)

[Handwritten response:] British Subject

[Stamped in blue ink 'GAZETTED G. of A. GAZETTE.', with handwritten date '11/1915' written inside stamp.]

8. Married or Single

[Handwritten response:] Single

9. Postal Address.

[Handwritten annotation in pencil: '229485 HP'.]

[Handwritten response:] Northam West Aust

Battalion Area.

[No response.]

10. Next of Kin.

[Handwritten response:] P.W. Armstrong[,] Hay Street[,] Perth W.A. (Brother-In-Law)

[Dividing line. New section.]

Date. [No response.]

(Signature of Applicant) [Handwritten signature: Hugo Throssell.

[In small text.] Note- Candidates for Commissions in the Permanent Forces are required to attach a satisfactory certificate of moral character, or, if they are serving in the Permanent or Citizen Forces, to be recommended by their Commanding Officer. They are also to state on the back of this form the subjects in which they desire to be examined in Part II, and where exemptions are claimed for educational subjects, the authority for same is to be stated, and where necessary to be supported by certificates.

[Bold subheading:] MEDICAL CERTIFICATE.

[In small text:] In the cases of Candidates for Commissions in the Permanent Forces, Proceedings of Medical Board, in accordance with instructions contained in "Standing Orders for the Army Medical Services" will be substituted for this Certificate; such Board, however, will not be assembled until after the nomination of the Candidate to undergo examination has been approved by the Military Board of Administration. [End small text.]

I, Edward Rogerson [name handwritten] do hereby certify to the correctness of the following particulars respecting the above-named applicant. I further certify that the applicant is not ruptured, has not been operated on for Hernia, and is capable of bearing the fatigue incident to the performance of military duty.

Height[:] 5ft 11in [response handwritten.]

Weight[:] 12 st 5lbs [response handwritten.]

Chest Measurement[:] 36/39 [response handwritten.]

Eyesight[:] 6/6   6/6 [response handwritten.]

Signature of the Examining Medical Officer[:] [Handwritten signature:] Edward Rogerson [illegible word.]

[Bold subheading:] RECOMMENDATION AND CERTIFICATE OF COMMANDING OFFICER.

[Small text.] (not required in the cases of Candidates for Commissions in the Permanent Forces.) [End small text]

I recommend that the candidate above named be appointed an officer [word handwritten] in the Corps under my command, and I certify:-

1. That such appointment will be within the authorized establishment for the current year.

2. (a) [Footnote. Footnote states: 'Sub-para not applicable to be struck out.'] That the provisions of U.T. Reg. 33 have been fully complied with, or

(b) [Footnote. Footnote states: 'Sub-para not applicable to be struck out.'] that the provisions of U.T. Reg. 132 have been fully complied with.

(c) That all candidates higher in order of merit, by competitive examination, have been absorbed.

On appointment the candidate will be posted to the [handwritten text] 2nd Reinforcement 15th Light Horse. [Crossed out text:] Squadron, Battery, or Coy, &c.

Date[:] 17-2-15 [date handwritten.]

[Illegible handwritten signature.]

Camp Commandant

[Bold subheading:] RECOMMENDATION OF DISTRICT COMMANDANT.

Recommended, candidate considered suitable.

[Stamped in purple ink 'A.G.']

Date: [Two dates in different handwriting: '3/5/15', and '20 Feby 1915'.]

[Illegible handwritten signature.]

Commandant 5 [number handwritten] Military District.

[Footer:] N.B.- Record of War Service (if any) to be shown on back of Form.