# AD-779

## EMPLOYEE BIOGRAPHICAL SKETCH

  --------- -------------- ------- ------- ------- ---------------- ------------- ----------------
  **1.                                                              **VACANCY          
  NAME:**                                                           NUMBER:**     

            **ELECTRONIC                                                          
            MAILING                                                               
            ADDRESS:**                                                            

            **SURFACE                                                             
            MAILING                                                               
            ADDRESS:**                                                            

                                                                                  

                                                                                  

            **PHONE                                                               
            NUMBER:**                                                             
  --------- -------------- ------- ------- ------- ---------------- ------------- ----------------

**2. EXPERIENCE:** *(List last 15 years, beginning with the most RECENT
DATE. Clearly identify any temporary promotions.)*

+----------------+-----------------------------+-----------------------+
| **DATES**      | **POSITION TITLE,           | **ORGANIZATION        |
|                | SPECIALTY**                 | NAME/LOCATION**       |
| ***(From       |                             |                       |
| MO/YR)***      | **SERIES, GRADE/STEP**      | **NAME & TELEPHONE    |
|                |                             | NO. OF**              |
|                |                             |                       |
|                |                             | **IMMEDIATE           |
|                |                             | SUPERVISOR**          |
+----------------+-----------------------------+-----------------------+
|                |                             |                       |
+----------------+-----------------------------+-----------------------+

**3. APPLICABLE EDUCATION AND TRAINING:** *(Beyond High School)*

  -------------- ------- ------- -----------------------------------------------------
  DEGREE:                        

  MAJOR/MINOR:                   

  DATE OF                             
  GRADUATION:                    
  -------------- ------- ------- -----------------------------------------------------

**4. LAST OFFICIAL PERFORMANCE RATING: (***Check Appropriate Level)*

  -- ------------- -- ---------- -- --------------- -- ---------- -- --------------
     Outstanding      Superior      Fully              Marginal      Unacceptable
                                    Successful                       

  -- ------------- -- ---------- -- --------------- -- ---------- -- --------------

#### OFFICIAL RATING MAY BE REQUESTED PRIOR TO SELECTION

  -------------------- -------------------- -- ----- -- ---------------- ----
  May we contact your                          YES      NO               
  supervisor without                                                     
  first notifying you?                                                   

  Current Supervisor's                                                   
  Name:                                                                  

  Supervisor's Work                                                      
  Phone:                                                                 
  -------------------- -------------------- -- ----- -- ---------------- ----

**5. LIST, BY DATE, ANY AWARDS, CITATIONS, OR SPECIAL ASSIGNMENTS:**

> **     **