JOB APPLICATION FORM FOR EMPLOYMENT WITH THE

**U.S. EMBASSY SEOUL, KOREA**

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<tbody>
<tr class="odd">
<td colspan="8"><h1 id="name-in-full">1. Name in full</h1>
<p>(Last) (First &amp; middle names)</p>
<p>           </p></td>
<td colspan="12"><p><strong>2. Job title in announcement</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="even">
<td colspan="8"><p><strong>3. Grade(s) applying for</strong></p>
<p>     </p></td>
<td colspan="12"><p><strong>4. Announcement number</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td colspan="8"><p><strong>5. Present address and telephone
number</strong></p>
<p>Address:      </p>
<p>Cell phone:      </p>
<p>Home phone:      </p>
<p>E-mail:      </p></td>
<td colspan="12"><p><strong>6-1. Are you a Korean citizen?</strong></p>
<p>Yes (Go to #7 and continue.)</p>
<p>No  Give the country of your citizenship.</p>
<p><u>           </u> (Answer #6-2)</p>
<p><strong>6-2. Do you have work permit to work in Korea?</strong></p>
<p>Yes  Please specify your visa category (Examples: F4 Visa, A3 SOFA).
<u>          </u></p>
<p>No </p></td>
</tr>
<tr class="even">
<td colspan="20"><p><strong>7. Do you claim veterans’
preference?</strong></p>
<p>No Yes  Mark your claim of 5 or 10 points below.</p>
<blockquote>
<p><strong>5 points</strong>  Attach your DD214. <strong>10
points</strong>  Attach an Application for 10-Point Veterans’
Preference (SF15) and proof required.</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="20"><p><strong>8. Were you ever a Federal civilian
employee?</strong></p>
<p>No Yes  For highest civilian grade give:</p>
<p>Series:            Grade:            From (MM/YY):            To
(MM/YY):           </p></td>
</tr>
<tr class="even">
<td colspan="20"><p><strong>9. Are you eligible for reinstatement based
on career or career-conditional Federal status?</strong></p>
<p>No Yes  If requested, attach SF50 proof.</p></td>
</tr>
<tr class="odd">
<td colspan="20"><strong>10. List any relatives or family members
employed by the U.S. Embassy or U.S. Armed Forces in Korea</strong></td>
</tr>
<tr class="even">
<td colspan="2">Name</td>
<td colspan="11">Relationship</td>
<td colspan="7">Department, Agency or branch of armed forces</td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td colspan="11">     </td>
<td colspan="7">     </td>
</tr>
<tr class="even">
<td colspan="2">     </td>
<td colspan="11">     </td>
<td colspan="7">     </td>
</tr>
<tr class="odd">
<td colspan="2">     </td>
<td colspan="11">     </td>
<td colspan="7">     </td>
</tr>
<tr class="even">
<td colspan="8"><em><strong>EDUCATION</strong></em></td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="20"><strong>11. Mark highest level completed.</strong> Some
HS HS/GED Associate Bachelor Master Doctoral </td>
</tr>
<tr class="even">
<td colspan="20"><p><strong>12. Last high school (HS) or GED school.
Give the school’s name, city, State, ZIP Code (if known), and year
diploma or GED received.</strong></p>
<p><strong>     </strong></p></td>
</tr>
<tr class="odd">
<td colspan="20"><strong>13. Colleges and universities attended. Do not
attach a copy of your transcript unless requested.</strong></td>
</tr>
<tr class="even">
<td colspan="4">Name of college or university</td>
<td colspan="6">Dates</td>
<td colspan="5" rowspan="2"><h2 id="degree-earned">Degree earned</h2>
<h2 id="ba-ma-ph.d-etc.">(BA, MA, Ph.D, etc.)</h2></td>
<td colspan="5" rowspan="2"><h2 id="majors">Major(s)</h2></td>
</tr>
<tr class="odd">
<td colspan="4">City</td>
<td colspan="3">From</td>
<td colspan="3">To</td>
</tr>
<tr class="even">
<td colspan="4">1)      </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="4">2)      </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="4">3)      </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="3" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
<td colspan="5" rowspan="2">     </td>
</tr>
<tr class="odd">
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="20"><p><em><strong>WORK EXPERIENCE</strong></em></p>
<p><strong>14. Describe your paid and nonpaid work experience related to
the job for which you are applying. Do not attach job
descriptions.</strong></p></td>
</tr>
<tr class="odd">
<td colspan="12"><ol type="1">
<li><p>Job title (if Federal, include series and grade)</p></li>
</ol>
<blockquote>
<p>     </p>
</blockquote></td>
<td colspan="8"><p>Reason for leaving</p>
<p>     </p></td>
</tr>
<tr class="even">
<td><p>From (MM/YY)</p>
<p>     </p></td>
<td colspan="4"><p>To (MM/YY)</p>
<p>     </p></td>
<td colspan="7"><p>Salary</p>
<p>$     </p></td>
<td colspan="5"><p>Per</p>
<p>     </p></td>
<td colspan="3"><p>Hours per week</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>Employer’s name and address</p>
<p>     </p></td>
<td colspan="8"><p>Supervisor’s name and phone number</p>
<p>     </p>
<p>(     )      </p></td>
</tr>
<tr class="even">
<td colspan="20"><p>Describe your duties and accomplishments</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><ol start="2" type="1">
<li><p>Job title (if Federal, include series and grade)</p></li>
</ol>
<blockquote>
<p>     </p>
</blockquote></td>
<td colspan="8"><p>Reason for leaving</p>
<p>     </p></td>
</tr>
<tr class="even">
<td><p>From (MM/YY)</p>
<p>     </p></td>
<td colspan="4"><p>To (MM/YY)</p>
<p>     </p></td>
<td colspan="7"><p>Salary</p>
<p>$     </p></td>
<td colspan="5"><p>Per</p>
<p>     </p></td>
<td colspan="3"><p>Hours per week</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>Employer’s name and address</p>
<p>     </p></td>
<td colspan="8"><p>Supervisor’s name and phone number</p>
<p>     </p>
<p>(      )      </p></td>
</tr>
<tr class="even">
<td colspan="20"><p>Describe your duties and accomplishments</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><ol start="3" type="1">
<li><p>Job title (if Federal, include series and grade)</p></li>
</ol>
<blockquote>
<p>     </p>
</blockquote></td>
<td colspan="8"><p>Reason for leaving</p>
<p>     </p></td>
</tr>
<tr class="even">
<td><p>From (MM/YY)</p>
<p>     </p></td>
<td colspan="4"><p>To (MM/YY)</p>
<p>     </p></td>
<td colspan="7"><p>Salary</p>
<p>$     </p></td>
<td colspan="5"><p>Per</p>
<p>     </p></td>
<td colspan="3"><p>Hours per week</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>Employer’s name and address</p>
<p>     </p></td>
<td colspan="8"><p>Supervisor’s name and phone number</p>
<p>     </p>
<p>(      )      </p></td>
</tr>
<tr class="even">
<td colspan="20"><p>Describe your duties and accomplishments</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><ol start="4" type="1">
<li><p>Job title (if Federal, include series and grade)</p></li>
</ol>
<blockquote>
<p>     </p>
</blockquote></td>
<td colspan="8"><p>Reason for leaving</p>
<p>     </p></td>
</tr>
<tr class="even">
<td><p>From (MM/YY)</p>
<p>     </p></td>
<td colspan="4"><p>To (MM/YY)</p>
<p>     </p></td>
<td colspan="7"><p>Salary</p>
<p>$     </p></td>
<td colspan="5"><p>Per</p>
<p>     </p></td>
<td colspan="3"><p>Hours per week</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>Employer’s name and address</p>
<p>     </p></td>
<td colspan="8"><p>Supervisor’s name and phone number</p>
<p>     </p>
<p>(      )      </p></td>
</tr>
<tr class="even">
<td colspan="20"><p>Describe your duties and accomplishments</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><ol start="5" type="1">
<li><p>Job title (if Federal, include series and grade)</p></li>
</ol>
<blockquote>
<p>     </p>
</blockquote></td>
<td colspan="8"><p>Reason for leaving</p>
<p>     </p></td>
</tr>
<tr class="even">
<td><p>From (MM/YY)</p>
<p>     </p></td>
<td colspan="4"><p>To (MM/YY)</p>
<p>     </p></td>
<td colspan="7"><p>Salary</p>
<p>$     </p></td>
<td colspan="5"><p>Per</p>
<p>     </p></td>
<td colspan="3"><p>Hours per week</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="12"><p>Employer’s name and address</p>
<p>     </p></td>
<td colspan="8"><p>Supervisor’s name and phone number</p>
<p>     </p>
<p>(      )      </p></td>
</tr>
<tr class="even">
<td colspan="20"><p>Describe your duties and accomplishments</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="20"><p><strong>15. May we approach your present
employer?</strong></p>
<p>Yes No  If we need to contact your current supervisor before making
an offer, we will contact you first.</p></td>
</tr>
<tr class="even">
<td colspan="20"><p><em>OTHER QUALIFICATIONS</em></p>
<p>15. Job-related training courses (give title and year). Job-related
skills (other languages, computer software/hardware, tools, machinery,
typing speed, etc). Job-related certificates and licenses (current
only). Job-related honors, awards, and special accomplishments
(publications, memberships in professional/honor societies, leadership
activities, public speaking, and performance awards.) Give dates, but do
not send documents unless requested.</p>
<p>     </p></td>
</tr>
<tr class="odd">
<td colspan="3" rowspan="2">16. Language(s)</td>
<td colspan="6"><p>Can prepare and</p>
<p>give lectures</p></td>
<td colspan="5">Can speak and understand</td>
<td colspan="4">Can translate articles</td>
<td colspan="2"><p>Can read articles</p>
<p>for own use</p></td>
</tr>
<tr class="even">
<td colspan="3">Fluently</td>
<td colspan="3">With Difficulty</td>
<td colspan="2">Fluently</td>
<td colspan="3">Passably</td>
<td colspan="2">Into English</td>
<td colspan="2">From English</td>
<td>Easily</td>
<td>With Difficulty</td>
</tr>
<tr class="odd">
<td colspan="3">1)      </td>
<td colspan="3">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
<td colspan="2">     </td>
<td>     </td>
<td>     </td>
</tr>
<tr class="even">
<td colspan="3">2)      </td>
<td colspan="3">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
<td colspan="3">     </td>
<td colspan="2">     </td>
<td colspan="2">     </td>
<td>     </td>
<td>     </td>
</tr>
<tr class="odd">
<td colspan="20"><h2 id="section"></h2>
<h2 id="applicant-certification"><em>APPLICANT CERTIFICATION</em></h2>
<p><strong>17. I certify</strong> that, to the best of my knowledge and
belief, all of the information on and attached to this application is
true, correct, complete and made in good faith<strong>. I
understand</strong> that false or fraudulent information on or attached
to this application may be grounds for not hiring me or firing me after
I begin work, and may be punishable by fine or imprisonment<strong>. I
understand</strong> that any information I give may be investigated.</p>
<p>Signature <u>                         </u> Date
               </p></td>
</tr>
</tbody>
</table>