+-----------------------------------------------------------------------+
| # General Information                                                 |
|                                                                       |
| **Optional Application for Federal Employment -- OF 612**             |
+-----------------------------------------------------------------------+
| You may apply for most Federal jobs with a résumé, an Optional        |
| Application for Federal Employment (OF 612), or other written format. |
| If your résumé or application does not provide all the information    |
| requested on this form and in the job vacancy announcement, you may   |
| lose consideration for a job. Type or\                                |
| print clearly in black ink. Help speed the selection process by       |
| keeping your application brief and sending only the requested         |
| information. If essential to attach additional pages, include your    |
| name and job announcement number on each page.                        |
|                                                                       |
| • Information on Federal employment and the latest information about  |
| educational and training provisions are available at                  |
| [www.usajobs.gov](http://www.usajobs.gov/) or via interactive\        |
| voice response system: (703) 724-1850 or TDD (978) 461-8404.          |
|                                                                       |
| • Upon request from the employing Federal agency, you must provide    |
| documentation or proof that your degree(s) is from a school           |
| accredited by an\                                                     |
| accrediting body recognized by the Secretary, U.S. Department of      |
| Education, or that your education meets the other provisions outlined |
| in the OPM\                                                           |
| Operating Manual. It will be your responsibility to secure the        |
| documentation that verifies that you attended and earned your         |
| degree(s) from this accredited\                                       |
| institution(s) (e.g., official transcript). Federal agencies will     |
| verify your documentation.                                            |
|                                                                       |
| > For a list of postsecondary educational institutions and programs   |
| > accredited by accrediting agencies and state approval agencies      |
| > recognized by the U.S. Secretary of Education, refer to the U.S.    |
| > Department of Education Office of Postsecondary Education website   |
| > at <http://www.ope.ed.gov/accreditation/>.                          |
| >                                                                     |
| > For information on Educational and Training Provisions or           |
| > Requirements, refer to the OPM Operating Manual available at        |
| > [http://www.opm.gov/\                                               |
| > qualifcations/SEC                                                   |
| -II/s2-e4.asp](http://www.opm.gov/%0Bqualifcations/SEC-II/s2-e4.asp). |
|                                                                       |
| • If you served on active duty in the United States Military and were |
| discharged or released from active duty in the armed forces under     |
| honorable conditions,\                                                |
| you may be eligible for veterans' preference. To receive preference,  |
| if your service began after October 15, 1976, you must have a         |
| Campaign Badge,\                                                      |
| Expeditionary Medal, or a service-connected disability. Veterans'     |
| preference is not a factor for Senior Executive Service jobs or when  |
| competition is\                                                       |
| limited to status candidates (current or former career-or             |
| career-conditional Federal employees).                                |
|                                                                       |
| • Most Federal jobs require United States citizenship and also that   |
| males over 18 born December 31, 1959, have registered with the        |
| Selective\                                                            |
| Service System or have an exemption.                                  |
|                                                                       |
| • The law generally prohibits public officials from appointing,       |
| promoting, or recommending their relatives.                           |
|                                                                       |
| • Federal annuitants (military and civilian) may have their salaries  |
| or annuities reduced. Every employee must pay any valid delinquent    |
| debt or the agency\                                                   |
| may garnish their salary.                                             |
|                                                                       |
| • Send your application to the office announcing the vacancy. If you  |
| have questions, contact the office identified in the announcement.    |
+-----------------------------------------------------------------------+
| **How to Apply**                                                      |
+-----------------------------------------------------------------------+
| 1.  **Review** the listing of current vacancies.                      |
|                                                                       |
| 2.  **Decide** which jobs, pay range, and locations interest you.     |
|                                                                       |
| 3.  **Follow instructions** provided in the vacancy announcement      |
|     including any additional forms that are required.                 |
|                                                                       |
| • You may apply for most jobs with a resume, this form, or any other  |
| written format; **all applications must include the information       |
| requested in the\                                                     |
| ** **vacancy announcement as well as information required for all     |
| application for Federal** **employment** (see below):                 |
|                                                                       |
| > • The USAJOBS website features an online résumé builder. This is a  |
| > free service that allows you to create a résumé, submit it          |
| > electronically (for some\                                           |
| > vacancy announcements), and save it online for use in the future.   |
|                                                                       |
| Certain information is required to evaluate your qualifications and   |
| determine if your meet legal requirements for Federal employment. If  |
| your résumé or\                                                       |
| application does not include all the required information as          |
| specified below, the agency may not consider you for the vacancy.     |
| Help speed the selection\                                             |
| process -- submit a concise résumé or application and send only the   |
| required material.                                                    |
|                                                                       |
| **Information required for all applications for Federal employment:** |
|                                                                       |
| ### Job Vacancy Specifics                                             |
|                                                                       |
| > • Announcement number, title and grade(s) of the job you are        |
| > applying for                                                        |
|                                                                       |
| ### Personal Information                                              |
|                                                                       |
| > • Full name, mailing address (with zip code) and day and evening    |
| > phone numbers (with area code) and email address, if applicable     |
| >                                                                     |
| > • Social Security Number                                            |
| >                                                                     |
| > • Country of citizenship (most Federal jobs require U.S.            |
| > citizenship)                                                        |
| >                                                                     |
| > • Veterans' preference                                              |
| >                                                                     |
| > • Reinstatement eligibility (for former Federal employees)          |
| >                                                                     |
| > • Highest Federal civilian grade held (including job series and     |
| > dates held)                                                         |
| >                                                                     |
| > • Selective Service (if applicable)                                 |
|                                                                       |
| #### Work Experience                                                  |
|                                                                       |
| > • Provide the following information for your paid and volunteer     |
| > work experience related to the job you are applying for:            |
| >                                                                     |
| >  job title (include job series and grade if Federal)               |
| >                                                                     |
| >  duties and accomplishments                                        |
| >                                                                     |
| >  employer's name and address                                       |
| >                                                                     |
| >  supervisor's name and telephone number -- indicate if supervisor  |
| > may be contacted                                                    |
| >                                                                     |
| >  starting and ending dates (month and year)                        |
| >                                                                     |
| >  hours per week                                                    |
| >                                                                     |
| >  salary                                                            |
+-----------------------------------------------------------------------+

+-----------------------------------------------------------------------+
| **How to Apply (continued)**                                          |
+-----------------------------------------------------------------------+
| #####                                                                 |
|                                                                       |
| ##### Education                                                       |
|                                                                       |
| -   High School                                                       |
|                                                                       |
| >  Name, city, and State (Zip code if known)                         |
| >                                                                     |
| >  Date of diploma or GED                                            |
|                                                                       |
| -   Colleges or universities                                          |
|                                                                       |
| >  Name, city, and State (Zip code if known)                         |
| >                                                                     |
| >  Majors                                                            |
| >                                                                     |
| >  Type and year of degrees received. (If no degree, show total      |
| > credits earned and indicate whether semester or quarter hours.)     |
|                                                                       |
| -   Do not attach a copy of your transcript unless requested          |
|                                                                       |
| -   Do not list degrees received based solely on life experience or   |
|     obtained from schools with little or no academic standards        |
|                                                                       |
| Upon request from the employing Federal agency, you must provide      |
| documentation or proof that your degree(s) is from a school           |
| accredited by an accrediting\                                         |
| body recognized by the Secretary, U.S. Department of Education, or    |
| that your education meets the other provisions outlined in the OPM    |
| Operating Manual. It\                                                 |
| will be your responsibility to secure the documentation that verifies |
| that you attended and earned your degree(s) from this accredited      |
| institution(s) (e.g., official transcript). Federal agencies will     |
| verify your documentation.                                            |
|                                                                       |
| For a list of postsecondary educational institutions and programs     |
| accredited by accrediting agencies and state approval agencies        |
| recognized by the U.S. Secretary of Education, refer to the U.S.      |
| Department of Education Office of Postsecondary Education website at  |
| <http://ww.ope.ed.gov/accreditation/>.                                |
|                                                                       |
| For information on Educational and Training Provisions or             |
| Requirements, refer to the OPM Operating Manual available at          |
| [http://www.opm.gov/qualifications/\                                  |
| SEC-                                                                  |
| II/s2-e4.asp](http://www.opm.gov/qualifications/%0BSEC-II/s2-e4.asp). |
|                                                                       |
| ##### Other Education Completed                                       |
|                                                                       |
| -   School name, city, State (Zip code if known)                      |
|                                                                       |
| >  Credits earned and Majors                                         |
| >                                                                     |
| >  Type and year of degrees received. (If no degree, show total      |
| > credits earned and indicate whether semester or quarter hours.)     |
|                                                                       |
| -   Do not list degrees received based solely on life experience or   |
|     obtained from schools with little or no academic standards        |
|                                                                       |
| ##### Other Qualifications                                            |
|                                                                       |
| -   Job-related:                                                      |
|                                                                       |
| >  Training (title of course and year)                               |
| >                                                                     |
| >  Skills (e.g., other languages, computer software/hardware, tools, |
| > machinery, typing speed, etc.)                                      |
| >                                                                     |
| >  Certificates or licenses (current only). Include type of license  |
| > or certificate, date of latest license, and State or other          |
| > licensing agency                                                    |
| >                                                                     |
| >  Honors, awards, and special accomplishments, (e.g., publications, |
| > memberships in professional honor societies, leadership activities, |
| > public\                                                             |
| > speaking and performance awards) (Give dates but do not send        |
| > documents unless requested)                                         |
|                                                                       |
| Any **Any Other information Specified in the Vacancy Announcement**   |
+-----------------------------------------------------------------------+
| ## Privacy Act Statement                                              |
|                                                                       |
| The U.S. Office of Personnel Management and other Federal agencies    |
| rate applicants for Federal jobs under the authority of sections      |
| 1104, 1302, 3301,\                                                    |
| 3304, 3320, 3361, 3393, and 3394 of title 5 of the United States      |
| Code. We need the information requested in this form and in the       |
| associated vacancy announcements to evaluate your qualifications.     |
| Other laws require us to ask about citizenship, military service,     |
| etc. In order to keep your records in order,\                         |
| we request your Social Security Number (SSN) under the authority of   |
| Executive Order 9397 which requires the SSN for the purpose of        |
| uniform, orderly administration of personnel records. Failure to      |
| furnish the requested information may delay or prevent action on your |
| application. We use your SSN to seek information about you from       |
| employers, schools, banks, and others who know you. We may use your   |
| SSN in studies and computer matching with other Government files. If  |
| you do not give us your SSN or any other information requested, we    |
| cannot process your application. Also, incomplete addresses and\      |
| ZIP Codes will slow processing. We may confirm information from your  |
| records with prospective nonfederal employers concerning tenure of    |
| employment,\                                                          |
| civil service status, length of service, and date and nature of       |
| action for separation as shown on personnel action forms of           |
| specifically identified individuals.                                  |
|                                                                       |
| **Public Burden Statement**                                           |
|                                                                       |
| We estimate the public reporting burden for this collection will vary |
| from 20 to 240 minutes with an average of 90 minutes per response,    |
| including time for reviewing instructions, searching existing data    |
| sources, gathering data, and completing and reviewing the             |
| information. Send comments regarding the\                             |
| burden statement or any other aspect of the collection of             |
| information, including suggestions for reducing this burden to the    |
| U.S. Office of Personnel\                                             |
| Management (OPM), OPM forms Officer, Washington, DC 20415-7900. The   |
| OMB number, 3206-0219, is currently valid. OPM may not collect this\  |
| information and you are not required to respond, unless this number   |
| is displayed. Do not send completed application forms to this         |
| address; follow\                                                      |
| directions provided in the vacancy announcement(s).                   |
|                                                                       |
| **THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER**           |
+-----------------------------------------------------------------------+

<table style="width:100%;">
<colgroup>
<col style="width: 17%" />
<col style="width: 0%" />
<col style="width: 12%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 12%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 8%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 20%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="16"><strong>OPTIONAL APPLICATION FOR FEDERAL EMPLOYMENT -
OF 612</strong></td>
<td><p>Form Approved</p>
<p>OMB No. 3206-0219</p></td>
</tr>
<tr class="even">
<td colspan="17"><p><strong>Section A – Applicant
Information</strong></p>
<p>Use Standard State Postal Codes (abbreviations). If outside the
United States of America, and you do not have a military address,</p>
<p>type or print “OV” in the State field (Block 6c) and fill in the
Country field (Block 6e) below, leaving the Zip Code field (Block 6d)
blank.</p></td>
</tr>
<tr class="odd">
<td colspan="8">1. Job title in announcement</td>
<td colspan="3">2. Grade(s) applying for</td>
<td colspan="6">3. Announcement number</td>
</tr>
<tr class="even">
<td colspan="8"><strong>     </strong></td>
<td colspan="3"><strong>     </strong></td>
<td colspan="6"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="6">4a. Last name</td>
<td colspan="5">4b. First and middle names</td>
<td colspan="6">5. Social Security Number</td>
</tr>
<tr class="even">
<td colspan="6"><strong>     </strong></td>
<td colspan="5"><strong>     </strong></td>
<td colspan="6"><strong>Not Required (leave blank)</strong></td>
</tr>
<tr class="odd">
<td colspan="11">6a. Mailing address</td>
<td colspan="6" rowspan="2"><p>7. Phone numbers (include area code,</p>
<p>if within the United States of America)</p></td>
</tr>
<tr class="even">
<td colspan="11" rowspan="2"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="4">7a. Daytime</td>
<td colspan="2"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="7">6b. City</td>
<td>6c. State</td>
<td colspan="3">6d. ZIP Code</td>
<td colspan="6">7b. Evening</td>
</tr>
<tr class="odd">
<td colspan="7"><strong>     </strong></td>
<td><strong>     </strong></td>
<td colspan="3"><strong>     </strong></td>
<td colspan="6"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="17">6e. Country (if not within the United States of
America)</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="17">8. Email address (if available)</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="17"><p><strong>Section B - Work Experience</strong></p>
<p>Describe your paid and non-paid work experience related to the job
for which you are applying. Do not attach job description.</p></td>
</tr>
<tr class="odd">
<td colspan="17">1. Job title (if Federal, include series and
grade)</td>
</tr>
<tr class="even">
<td colspan="17"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="2">2. From <em>(mm/yyyy)</em></td>
<td colspan="3">3. To <em>(mm/yyyy)</em></td>
<td colspan="4">4. Salary</td>
<td>per</td>
<td colspan="7">5. Hours per week</td>
</tr>
<tr class="even">
<td colspan="2"><strong>     </strong></td>
<td colspan="3"><strong>     </strong></td>
<td colspan="4"><strong>$      </strong></td>
<td><strong>     </strong></td>
<td colspan="7"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="10">6. Employer’s name and address</td>
<td colspan="7">7. Supervisor’s name and phone number</td>
</tr>
<tr class="even">
<td colspan="10" rowspan="2"><strong>     </strong></td>
<td colspan="3">7a. Name</td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="3">7b. Phone</td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="4">8. May we contact your current supervisor?</td>
<td colspan="6">Yes No </td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="17">If we need to contact your current supervisor before
making an offer, we will contact you first.</td>
</tr>
<tr class="even">
<td colspan="17">9. Describe your duties, accomplishments and related
skills (if you need to attach additional pages, include your name,
address, and job<br />
announcement number)</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="17"><strong>Section C – Additional Work
Experience</strong></td>
</tr>
<tr class="odd">
<td colspan="17">1. Job title (if Federal, include series and
grade)</td>
</tr>
<tr class="even">
<td colspan="17"><strong>     </strong></td>
</tr>
<tr class="odd">
<td>2. From <em>(mm/yyyy)</em></td>
<td colspan="4">3. To <em>(mm/yyyy)</em></td>
<td colspan="4">4. Salary</td>
<td colspan="3">per</td>
<td colspan="5">5. Hours per week</td>
</tr>
<tr class="even">
<td><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
<td colspan="4"><strong>$</strong><strong>     </strong></td>
<td colspan="3"><strong>     </strong></td>
<td colspan="5"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="12">6. Employer’s name and address</td>
<td colspan="5">7. Supervisor’s name and phone number</td>
</tr>
<tr class="even">
<td colspan="12" rowspan="2"><strong>     </strong></td>
<td colspan="2">7a. Name</td>
<td colspan="3"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="2">7b. Phone</td>
<td colspan="3"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="3">8. May we contact your current supervisor?</td>
<td colspan="14">Yes No </td>
</tr>
<tr class="odd">
<td colspan="17">If we need to contact your current supervisor before
making an offer, we will contact you first.</td>
</tr>
<tr class="even">
<td colspan="17">9 Describe your duties, accomplishments and related
skills (if you need to attach additional pages, include your name,
address, and job<br />
announcement number)</td>
</tr>
<tr class="odd">
<td colspan="17"><strong>     </strong></td>
</tr>
</tbody>
</table>

<table>
<colgroup>
<col style="width: 10%" />
<col style="width: 4%" />
<col style="width: 4%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 2%" />
<col style="width: 0%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 0%" />
<col style="width: 5%" />
<col style="width: 4%" />
<col style="width: 1%" />
<col style="width: 2%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 6%" />
<col style="width: 19%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="28"><p><strong>Section D – Education</strong></p>
<p>Upon request from employing Federal agency, you must provide
documentation or proof that your degree(s) is from a school accredited
by an accrediting body recognized by the Secretary, U.<br />
S. Department of Education, or that your education meets the other
provisions outlined in the OPM Operating Manual. It will be your
responsibility to secure the documentation that verifies that<br />
you attended and earned your degree(s) from this accredited
institution(s) (e.g., official transcript). Federal agencies will verify
your documentation.</p>
<p>For a list of postsecondary educational institutions and programs
accredited by accrediting agencies and state approval agencies
recognized by the U.S. Secretary of Education, refer to the U.S.
Department of Education Office of Postsecondary Education website at <a
href="http://www.ope.ed.gov/accreditation/">http://www.ope.ed.gov/accreditation/</a>.</p>
<p>For information on Educational and Training Provisions of
Requirements, refer to the OPM Operating Manual available at <a
href="http://www.opm.gov/qualifications /SEC-ll/s2-e4.asp">http://www.opm.gov/qualifications
/SEC-ll/s2-e4.asp</a></p>
<p>Do not list degrees received based solely on life experience or
obtained from schools with little or no academic standards.</p></td>
</tr>
<tr class="even">
<td colspan="28">1. Last High School (HS)/GED school. Give the school’s
name, city, state, ZIP Code (if known), and year diploma or GED
received:</td>
</tr>
<tr class="odd">
<td colspan="28"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="28">2. Mark highest level completed: Some HS HS/GED
Associate Bachelor Master Doctoral </td>
</tr>
<tr class="odd">
<td colspan="15">3. Colleges and universities attended.<br />
Do not attach a copy of your transcript unless requested.</td>
<td colspan="7"><p>Total Credits Earned</p>
<p>Semester Quarter</p></td>
<td colspan="5">Major(s)</td>
<td><p>Degree (if any),</p>
<p>Year Received</p></td>
</tr>
<tr class="even">
<td colspan="15">3a. Name</td>
<td colspan="5"></td>
<td colspan="2"></td>
<td colspan="5" rowspan="4"><strong>     </strong></td>
<td rowspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="15"><strong>     </strong></td>
<td colspan="5" rowspan="3"><strong>     </strong></td>
<td colspan="2" rowspan="3"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="6">City</td>
<td colspan="3">State</td>
<td colspan="6">Zip Code</td>
</tr>
<tr class="odd">
<td colspan="6"><strong>     </strong></td>
<td colspan="3"><strong>    </strong></td>
<td colspan="6"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="15">3b. Name</td>
<td colspan="5" rowspan="5"><strong>     </strong></td>
<td colspan="2" rowspan="5"><strong>     </strong></td>
<td colspan="5" rowspan="5"><strong>     </strong></td>
<td rowspan="5"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="15"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="6">City</td>
<td colspan="3">State</td>
<td colspan="6">Zip Code</td>
</tr>
<tr class="odd">
<td colspan="6"><strong>     </strong></td>
<td colspan="3"><strong>    </strong></td>
<td colspan="6"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="6"></td>
<td colspan="3"></td>
<td colspan="6"></td>
</tr>
<tr class="odd">
<td colspan="15">3c. Name</td>
<td colspan="5" rowspan="4"><strong>     </strong></td>
<td colspan="2" rowspan="4"><strong>     </strong></td>
<td colspan="5" rowspan="4"><strong>     </strong></td>
<td rowspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="15"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="6">City</td>
<td colspan="3">State</td>
<td colspan="6">Zip Code</td>
</tr>
<tr class="even">
<td colspan="6"><strong>     </strong></td>
<td colspan="3"><strong>    </strong></td>
<td colspan="6"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="28"><p><strong>Section E - Other Education
Completed</strong></p>
<p>Do not list degrees received based solely on life experience or
obtained from schools with little or no academic standards.</p></td>
</tr>
<tr class="even">
<td colspan="28"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="28"><strong>Section F – Other Qualifications</strong></td>
</tr>
<tr class="even">
<td colspan="10">License or Certificate</td>
<td colspan="14">Date of Latest License or Certificate</td>
<td colspan="4">State or Other Licensing Agency</td>
</tr>
<tr class="odd">
<td colspan="10">1f. <strong>     </strong></td>
<td colspan="14"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="10">2f. <strong>     </strong></td>
<td colspan="14"><strong>     </strong></td>
<td colspan="4"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="28"><p><strong>Section G – Other
Qualifications</strong></p>
<p><strong>Job-related</strong> training courses (give title and year).
<strong>Job-related</strong> skills (other languages, computer
software/hardware, tools, machinery, typing speed, etc.).</p>
<p><strong>Job-related</strong> honors, awards, and special
accomplishments (publication, membership in professional/honor
societies, leadership activities.</p>
<p>public speaking and performance awards). Give dates, but do
<strong>not</strong> send documents unless requested.</p></td>
</tr>
<tr class="even">
<td colspan="28"><h2 id="section-1">     </h2></td>
</tr>
<tr class="odd">
<td colspan="28"><h2 id="section-h---general">Section H -
General</h2></td>
</tr>
<tr class="even">
<td colspan="3">1a. Are you a U.S. citizen?</td>
<td colspan="4">Yes </td>
<td colspan="5">No </td>
<td colspan="2"></td>
<td colspan="11">1b. If no, give the country of your citizenship.</td>
<td colspan="3"><strong>     </strong></td>
</tr>
<tr class="odd">
<td colspan="8">2a. Do you claim veterans’ preference?</td>
<td colspan="5">Yes </td>
<td colspan="3">No </td>
<td colspan="2"></td>
<td colspan="10">If yes, mark your claim of 5 or 10 points below.</td>
</tr>
<tr class="even">
<td>2b. 5 points</td>
<td></td>
<td colspan="2"></td>
<td colspan="24">Attach your <em>Report of Separation from Active
Duty</em> (DD 214) or other proof.</td>
</tr>
<tr class="odd">
<td>2c. 10 points</td>
<td></td>
<td colspan="2"></td>
<td colspan="24">Attach an <em>Application for 10-Point Veterans’
Preference</em> (SF 15) and proof required.</td>
</tr>
<tr class="even">
<td colspan="28">3. Check this box if you are an adult make born on or
after January 1<sup>st</sup> 1960, and you registered for Selective
Service between the ages<br />
of 18 through 25 </td>
</tr>
<tr class="odd">
<td colspan="11">4. Were you ever a Federal civilian employee?</td>
<td colspan="4">Yes </td>
<td colspan="4">No </td>
<td colspan="2"></td>
<td colspan="7">If yes, list highest civilian grade for the
following:</td>
</tr>
<tr class="even">
<td colspan="5">4a. Series</td>
<td colspan="12">4b. Grade</td>
<td colspan="9">4c. From <em>(mm/yyyy)</em></td>
<td colspan="2">4d. To <em>(mm/yyyy)</em></td>
</tr>
<tr class="odd">
<td colspan="5"><strong>     </strong></td>
<td colspan="12"><strong>     </strong></td>
<td colspan="9"><strong>     </strong></td>
<td colspan="2"><strong>     </strong></td>
</tr>
<tr class="even">
<td colspan="28"><p>5a. Are you eligible for reinstatement based on
career or career-conditional Federal status? Yes No </p>
<p>If requested in the vacancy announcement, attach <em>Notification of
Personnel Action</em> (SF 50), as proof.</p></td>
</tr>
<tr class="odd">
<td colspan="28"><p>5b. Are you eligible under the ICTAP*? Yes No </p>
<p>*ICTAP (Interagency Career Transition Assistance Plan): A participant
in this plan is a current or former employee displaced from a Federal
agency. To be eligible, you<br />
must have received a formal notice of separation such as a RIF
separation notice. If you are an ICTAP eligible, normally you will be
provided priority consideration for<br />
vacancies within your commuting area for which you apply and are well
qualified.</p></td>
</tr>
<tr class="even">
<td colspan="28"><strong>Section I – Applicant
Certification</strong></td>
</tr>
<tr class="odd">
<td colspan="28">I certify 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<br />
faith. I understand that false or fraudulent information on or attached
to this application may be grounds for not hiring me or for firing me
after I begin work,<br />
and may be punishable by fine or imprisonment. I understand that any
information I give may be investigated.</td>
</tr>
<tr class="even">
<td colspan="23">1a. Signature</td>
<td colspan="5">1b. Date <em>(mm/dd/yyyy)</em></td>
</tr>
<tr class="odd">
<td colspan="23"><strong>     </strong></td>
<td colspan="5"><strong>     </strong></td>
</tr>
</tbody>
</table>