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‚˙˙˙ž€‚„˙ Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙žžââ‚ Small_label„˙ é‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙ ‚˙˙˙€€â‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙â‚„˙ ‚˙˙˙€â€‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙˙Cž‚„˙ ‚˙˙˙€ž€‚„˙ ‚˙˙˙âžâ‚„˙ ‚˙˙˙žâž‚„˙ ‚˙˙˙ž€‚„˙ Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙žžââ‚ Table_9point„˙ Ŕč‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙ ‚˙˙˙€€â‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙â‚„˙ ‚˙˙˙€â€‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙˙Cž‚„˙ ‚˙˙˙€ž€‚„˙ ‚˙˙˙âžâ‚„˙ ‚˙˙˙žâž‚„˙ ‚˙˙˙ž€‚„˙ Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙˙)ř đ-"‚„˙ ‚˙‚ ˙˙˙Ŕœ‚„˙ h˙Standard Form 171‚˙˙˙0Čć,č‚„˙ Ě˙0-BApplication for Federal EmploymentB‚˙˙˙řđ-"‚„˙ ˙˙˙Č˙RORead The Following Instructions Carefully Before You Complete This Application‚˙˙˙đ˛@„‚„˙ Œ˙74DO NOT SUBMIT A RESUME INSTEAD OF THIS APPLICATION.‚˙˙˙đ÷Ô‚„˙ Œ˙&#TYPE OR PRINT CLEARLY IN DARK INK.‚˙˙˙đ@¨. ‚„˙ Œ˙'$BIF YOU NEED MORE SPACE for an answer, use a sheet of paper the same size as this page.B On each sheet write your name, Social Security Number, the announcement number or job title, and the item number. Attach all additional forms and sheets to this application at the top of page 3.‚˙˙˙đŘ ¨^ ‚„˙ Œ˙Ž‹If you do not answer BallB questions fully and correctly, you may delay the review of your application and lose job opportunities.‚˙˙˙đ¨J‚„˙ Œ˙ŠBUnless you are asked for additional material in the announcement or qualification information, do not attachB any materials, such as: official position descriptions, performance evaluations, letters of recommendation, certificates of training, publications, etc. Any materials you attach which were not asked for may be removed from your application and will not be returned to you.‚˙˙˙đş¨¨‚„˙ Œ˙41BWe suggest that you keep a copyB of this application for your use. If you plan to make copies of your application, we suggest you leave itemsB 1, 48 and 49 Bblank. Complete these blank items each items each time you apply.B YOU MUST SIGN AND DATE, IN INK, EACH COPY YOU SUBMIT.B‚˙˙˙đލ‚„˙ Œ˙ŠŚBTo apply for a specific Federal civil service examinationB (whether or not a written test is required) orB a specific vacancy in an Federal agency:B‚˙˙˙2xšJ‚„˙ Œ˙74Read the announcement and other materials provided.‚˙˙˙2ČšN‚„˙ Œ˙heMake sure that your work experience and/or education meet the qualification requirements described.‚˙˙˙2Şšä‚„˙ Œ˙ÇÄMake sure the announcement is open for the job and location you are interested in. Announcements may be closed to receipt of applications for some types of jobs, grades, or geographic locations.‚˙˙˙2šX ‚„˙ Œ˙¸ľMake sure that you are allowed to apply. Some jobs are limited to veterans, or to people who work for the Federal Government or have worked for the Federal Government in the past.‚˙˙˙2Ś šÔ$‚„˙ Œ˙yvFollow any directions on "How to Apply". If a written test is required, bring any material you are instructed to bring to the test session. For example, you may be instructed to "Bring a completed SF 171 to the test." If a written test is not required, mail this application and all other forms required by the announcement to the address specified in the announcement.‚˙˙˙C%_Ł&‚„˙ ˙Work Experience (Item 24)‚˙˙˙đ¨&ŕ–)‚„˙ Œ˙  Carefully complete each experience block you need to describe your work experience. Unless you qualify based on education alone,B your rating will depend on your description of previous jobs. Do not leave out any jobs you held during the last ten years.B‚˙˙˙đđ)ŕŢ,‚„˙ Œ˙JGUnderB Description of WorkB, write a BclearB and Bbrief,B but BcompleteB description of your major duties and responsibilities for each job. Include any supervisory duties, special assignments, and your accomplishments in the job. We may verify your description with your former employers.‚˙˙˙đP-ŕÖ.‚„˙ Œ˙‘ŽIf you had a major change of duties or responsibilities while you worked for the same employer, describe each major change as a separate job.‚˙˙˙ě´/ä-Ě0‚„˙ ‚˙‚ ˙˙˙ěŔ/ä-Î0‚„˙ ˙˙˙Č˙,)Privacy Act and Public Burden Statements‚˙˙˙A1uă4‚„˙ x˙~The Office of Personnel Management is authorized to rate applicants for Federal jobs under sections 1302, 3301, and 3304 of title 5 of the U.S. Code. Section 1104 of title 5 allows the Office of Personnel Management to authorize other Federal agencies to rate applicants for Federal jobs. We need the information you put on this form and associated application forms to see how well your education and work skills qualify you for a Federal job. We also need information on matters such as citizenship and military service to see whether you are affected by laws we must follow in deciding who may be employed by the Federal Government.‚˙˙˙85uÚ8‚„˙ x˙{xWe must have your Social Security Number (SSN) to keep your records straight because other people may have the same name and birth date. The SSN has been used to keep records since 1943, when Executive Order 9397 asked agencies to do so. The Office of Personnel Management may also use your SSN to make requests for information about you from employers, schools, banks, and others who know you, but only as allowed by law or Presidential directive. The information we collect by using your SSN will be used for employment purposes and also may be used for studies, statistics, and computer matching to benefit and payment files.‚˙˙˙/9uă9‚„˙ x˙fcInformation we have about you may also be given to Federal, State, and local agencies for checking‚˙˙˙m+¨‚„˙ ˙*'Veteran Preference in Hiring (Item 22)‚˙˙˙@ć+Ž‚„˙ Œ˙—”BDO NOT LEAVE Item 22 BLANKB. If you do not claim veteran preference, place an B"X"B in the box next toB "NO PREFERENCE"B.‚˙˙˙@ôć+. ‚„˙ Œ˙ŢŰYou BcannotB receive veteran preference if you are retired or plan to retire at or above the rank of major or lieutenant commander, BunlessB you are disabled or retired from the active military Reserve.‚˙˙˙@Ě ć+ş‚„˙ Œ˙ńîTo receive veteran preference your separation from active duty must have been under honorable conditions. This includes honorable and general discharges. A clemencydischarge does not meet the requirements of the Veteran Preference Act.‚˙˙˙@ ć+‚„˙ Œ˙œ™BActive duty for training in the military Reserve and National Guard programs is not considered active duty for purposes of veteran preference.B‚˙˙˙@rć+‚„˙ Œ˙VSBTo qualify for preference you must meet ONEB of the following conditions:‚˙˙˙Şř+ä‚„˙ Œ˙ĘÇServed on active duty anytime between December 7, 1941, and July 1, 1955; (If you were a Reservist called to active duty between February 1, 1955 and July 1, 1955, you must meet condition 2, below.)‚˙˙˙ž¤Ü+v‚„˙ Œ˙or‚˙˙˙Tř+Ž‚„˙ Œ˙ÓĐServed on active duty any part of which was between July 2, 1955 and October 14, 1976 or a Reservist called to active duty between February 1, 1955 and October 14, 1976 and who served for more than 180 days;‚˙˙˙žnÜ+@‚„˙ Œ˙or‚˙˙˙ř+ ‚„˙ Œ˙ńîEntered on active duty between October 15, 1976 and September 7, 1980 or a Reservist who entered on active duty between October 15, 1976 and October 13, 1982 and received a Campaign Badge or Expeditionary Medal or are a disabled veteran;‚˙˙˙˘Î+l‚„˙ Œ˙or‚˙˙˙Mř+Ó‚„˙ Œ˙Š‡Enlisted in the Armed Forces after September 7, 1980 or entered active duty other than by enlistment on or after October 14, 1982 and:‚˙˙˙TüŔ+ę‚„˙ Œ˙completed 24 months of continuous active duty or the full period called or ordered to active duty, or were discharged under 10 U.S.C. 1171 or for hardship under 10 U.S.C. 1173 BandB received or were entitled to receive a Campaign Badge or Expeditionary Medal;B orB‚˙˙˙bčz+Č ‚„˙ Œ˙are a disabled veteran.‚˙˙˙@Ś%ě+”(‚„˙ Œ˙If you think you qualify for 10-Point Preference, review the requirements described in the Standard Form (SF) 15, Application for 10-Point Veteran Preference. The SF is available from any Federal Job Information Center. The 10-point preference groups are:‚˙˙˙)¸-ţ+‚„˙ Œ˙Ŕ˝Non-Compensably Disabled or Purple Heart Recipient. Compensably Disabled (less than 30%). Compensably Disabled (30% or more). Spouse, Widow(er) or Mother of a deceased or disabled veteran.‚˙˙˙@—!ě+…$‚„˙ Œ˙If you meet one of the four conditions above, you qualify for 5-point preference. If you want to claim 5-point preference BandB do not meet the requirements for 10-point preference, discussed below, place and B"X"B in the box next to B"5-POINT PREFERENCE".B‚˙˙˙@d,ě+R/‚„˙ Œ˙˙üIf you claim 10-point preference, place an B"X"B in the box next to the group that applies to you. To receive B10-point preference you must attach a completed SF 15 to this application together with the proof requested in the SF 15.B‚˙˙˙`>1¸-´3‚„˙ x˙b_on law violations or for other lawful purposes. We may send your name and address to State and local Government agencies, Congressional and other public offices, and public international organizations, if they request names of people to consider for employment. We may also notify your school placement office if you are selected for a Federal job.‚˙˙˙`ö3¸-Ö5‚„˙ x˙Giving us your SSN or any of the other information is voluntary. However, we cannot process your application, which is the first step toward getting a job, if you do not give us the information we request. Incomplete addresses and ZIP Codes will also slow processing.‚˙˙˙`6¸-H:‚„˙ x˙żźPublic burden reporting for this collection of information is estimated to vary from 20 to 360 minutes with an average of 50 minutes per response, including time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden to Reports and Forms Management Officer, U.S. Office of Personnel Management, 1900 E Street, N.W., Room 6410, Washington, D.C. 20415; and to the Office of Management and Budget, Paperwork Reduction Project (3206-0012), Washington, D.C. 20503.‚˙˙˙ěN;äR<‚„˙ đ˙PĘDETACH THIS PAGEP˙‚˙˙˙Hý€5‚„˙ ‚˙‚ ˙˙˙HQ€‰‚„˙ ‚˙‚ ˙˙˙H‘€É‚„˙ ‚˙‚ ˙˙˙H) €a ‚„˙ ‚˙‚ ˙˙˙HY€‘‚„˙ ‚˙‚ ˙˙˙H €D‚„˙ ‚˙‚ ˙˙˙HÝ€‚„˙ ‚˙‚ ˙˙˙`Y˜‘‚„˙ ‚˙‚ ˙˙˙`C ˜{ ‚„˙ ‚˙‚ ˙˙˙` ˜U ‚„˙ ‚˙‚ ˙˙˙`[˜“‚„˙ ‚˙‚ ˙˙˙`ż˜÷‚„˙ ‚˙‚ ˙˙˙`î!˜&"‚„˙ ‚˙‚ ˙˙˙`ń%˜)&‚„˙ ‚˙‚ ˙˙˙`ł,˜ë,‚„˙ ‚˙‚ ˙˙˙°H‚„˙ Œ˙4.‚˙˙˙°Łu‚„˙ Œ˙1.‚˙˙˙°K‚„˙ Œ˙2.‚˙˙˙°ë‚„˙ Œ˙3.‚˙˙˙HĄ&(s'‚„˙ Œ˙1.‚˙˙˙Hé)(ť*‚„˙ Œ˙2.‚˙˙˙HO-(!.‚„˙ Œ˙3.‚˙˙˙ŹŒÔ‚„˙ Œ˙a.‚˙˙˙ŹčŒş ‚„˙ Œ˙b.‚˙˙˙Fv1‚Applicant_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Rƒ1„#!Enter the city of your residence.…†˙˙‡˙U˙ç‚Highest_goverment_positionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚`ƒ…†˙˙‡˙r[.L ‚„˙ ‚˙‚ €€€˙˙˙rL/.K ‚„˙ ˙˙˙Č˙2/MILITARY SERVICE AND VETERAN PREFERENCE(Cont.)‚˙˙˙hŽ&)8‚„˙  ‚˙‚ €€€˙˙˙˙˙˙ö#K¤*+ ‚„˙ Œ˙Veteran Preference‚Ń˙X$hÇ-+‚Form_approvedƒText_field_small„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒ+„:8Enter the person who approved this application (if any).…†˙˙‡˙I$ڏ-i‚Form_reviewedƒText_field_small„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒi„1/Enter the person who reviewed this application.…†˙˙‡˙rŁIu‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙žLÖ ‚„˙ h˙/,Application for Federal Employment - SF 171‚˙˙˙žÁFË‚„˙  ˙b_Read the instructions before you complete this application. Type or print clearly in dark ink.‚˙˙˙žšžg‚„˙ ‚˙‚ ˙˙˙,„ÔG‚„˙ Œ˙]ZWhat kind of job are you applying for? IGive title and announcement no. (if any)I‚˙˙˙,ŰDŰ‚„˙  ‚˙˙*íň Ą‚„˙ Œ˙Social Security Number‚˙˙˙& íĄ‚„˙ Œ˙Sex‚˙˙˙,Ő DŐ ‚„˙  ‚˙˙$î < Ŕ ‚„˙ Œ˙ Birth date (Month, Day Year)‚˙˙˙şą D• ‚„˙ €€€‚˙‚ €€€˙˙˙˙˙˙$Ÿ < q ‚„˙ Œ˙Name (Last, First, Middle)‚˙˙˙,yDy‚„˙  ‚˙˙(ƒŚU‚„˙ Œ˙63Mailing Address (include apartment number, if any)‚˙˙˙,}D}‚„˙  ‚˙˙(}ÄO‚„˙ Œ˙City‚˙˙˙8}^O‚„˙ Œ˙ State‚˙˙˙$}ŔO‚„˙ Œ˙ Zip Code‚˙˙˙˛9Z‚„˙ €€€‚˙‚ €€€˙˙˙˙˙˙(5„‚„˙ Œ˙=:Other names ever used (e.g., maiden name, nickname, etc.)‚˙˙˙,YDY‚„˙  ‚˙˙(YČ +‚„˙ Œ˙ Home Phone‚˙˙˙,ÁDÁ‚„˙  ‚˙˙p Yf5‚„˙ Œ˙ Work Phone‚˙˙˙ýkĎ‚„˙ Œ˙ Area Code‚˙˙˙Z ý´Ď‚„˙ Œ˙ Area Code‚˙˙˙Á‚„˙  ‚˙˙rrÁ‚„˙  ‚˙˙lýĆ Ď‚„˙ Œ˙ Number‚˙˙˙ŕý:Ď‚„˙ Œ˙ Number‚˙˙˙šóôĹ‚„˙ Œ˙Ext.‚˙˙˙(ÇM‚„˙ Œ˙¸ľWere you ever employed as a civilian by the Federal Government? If B"NO"B go to BItem 11. BIf B"YES"B, mark each type of job you held with an B"X"B.‚˙˙˙(ůË‚„˙ Œ˙DAWhat is your highest grade, classification series and job title?‚˙˙˙(Łn u‚„˙ Œ˙Dates at highest grade:‚˙˙˙B Łh u‚„˙ Œ˙FROM‚˙˙˙ŢŁu‚„˙ Œ˙TO‚˙˙˙˛uu‚„˙ (‚˙˙źg.C ‚„˙ ‚˙‚ ˙˙˙ń[ i ‚„˙ ˙˙˙Č˙ AVAILABILITY‚˙˙˙I B Ď!‚„˙ Œ˙-*When can you start work? (Month and Year)‚˙˙˙h I ÖĎ!‚„˙ Œ˙jgWhat is the BlowestB pay you will accept? (You will not be considered for jobs which pay less)‚˙˙˙Eo##o#‚„˙  ‚˙˙h ł"Ž …#‚„˙ Œ˙ Pay $‚˙˙˙ł"ś…#‚„˙ Œ˙per‚˙˙˙`ł"ş…#‚„˙ Œ˙BORB Grade‚˙˙˙(Ą#hs$‚„˙ Œ˙74In what geographic area(s) are you willing to work?‚˙˙˙Dł&ł&‚„˙  ‚˙˙(ż&h‘'‚„˙ Œ˙Are you willing to work:‚˙˙˙f´&ă,‚Willing_to_work_hours„˙ ‚fJř'ş(—)m*?+,ă,Bfř'Jş(‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒş(„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙fş(JŒ)‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒŒ)„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f—)Ji*‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒi*„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙fm*J?+‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ?+„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f?+J,‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f,Jă,‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒă,„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙Jř'ş(‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒş(„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙Jş(Œ)‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒŒ)„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J—)i*‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒi*„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙Jm*?+‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒ?+„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J?+,‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒ,„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J,ă,‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒă,„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙fř'fă,‚„˙  ‚˙˙˙Jř'Jă,‚„˙  ‚˙˙˙ř'ă,‚„˙  ‚˙˙˙fř'ř'‚„˙  ‚˙˙˙fş(ş(‚„˙  ‚˙˙˙f—)—)‚„˙  ‚˙˙˙fm*m*‚„˙  ‚˙˙˙f?+?+‚„˙  ‚˙˙˙f,,‚„˙  ‚˙˙˙fă,ă,‚„˙  ‚˙˙˙˙Cf´&fř'‚„˙  ‚˙˙˙J´&Jř'‚„˙  ‚˙˙˙´&ř'‚„˙  ‚˙˙˙f´&´&‚„˙  ‚˙˙˙f´&Jř'‚„˙ Č˙Yes‚ ˙‚ ˙˙˙˙˙˙˙J´&ř'‚„˙ Č˙No‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙d(°Ů(‚„˙ Œ˙%"A. 40 hours per week (full-time)?‚˙˙˙dť(fť(‚„˙  ‚˙˙dŮ(°Ť)‚„˙ Œ˙(%B. 25-32 hours per week (part-time)?‚˙˙˙d—)f—)‚„˙  ‚˙˙dľ)°‡*‚„˙ Œ˙(%C. 17-24 hours per week (part-time)?‚˙˙˙dm*fm*‚„˙  ‚˙˙dŒ*°^+‚„˙ Œ˙.+D. 16 or fewer hours per week (part-time)?‚˙˙˙dF+fF+‚„˙  ‚˙˙d^+°0,‚„˙ Œ˙.+E. An intermittent job (on-call/seasonal)?‚˙˙˙d,f,‚„˙  ‚˙˙d0,°-‚„˙ Œ˙,)F. Weekends, shifts, or rotating shifts?‚˙˙˙Eä,mä,‚„˙  ‚˙˙eĐ-,0‚Willing_to_work_months„˙ ‚eIĐ-—.Z/,0BeĐ-I—.‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ—.„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙e—.IZ/‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒZ/„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙eZ/I,0‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,0„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙IĐ-—.‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ—.„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙I—.Z/‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒZ/„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙IZ/,0‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,0„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙eĐ-e,0‚„˙  ‚˙˙˙IĐ-I,0‚„˙  ‚˙˙˙Đ-,0‚„˙  ‚˙˙˙eĐ-Đ-‚„˙  ‚˙˙˙e—.—.‚„˙  ‚˙˙˙eZ/Z/‚„˙  ‚˙˙˙e,0,0‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙ç,Vš-‚„˙ Œ˙Are you willing to work:‚˙˙˙h—.j—.‚„˙  ‚˙˙Rž.žp/‚„˙ Œ˙B. 1 to 4 months ?‚˙˙˙hZ/jZ/‚„˙  ‚˙˙Rx/žJ0‚„˙ Œ˙C. Less than 1 months ?‚˙˙˙C,0k,0‚„˙  ‚˙˙fń03‚Willing_to_travel_days„˙ ‚fJń0Ę1œ23Bfń0JĂ1‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒĂ1„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙fĘ1Jœ2‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒœ2„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙fœ2Jn3‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒn3„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙Jń0Ă1‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒĂ1„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙JĘ1œ2‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒœ2„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙Jœ2n3‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒn3„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙fń0f3‚„˙  ‚˙˙˙Jń0J3‚„˙  ‚˙˙˙ń03‚„˙  ‚˙˙˙fń0ń0‚„˙  ‚˙˙˙fĘ1Ę1‚„˙  ‚˙˙˙fœ2œ2‚„˙  ‚˙˙˙f33‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙;0U 1‚„˙ Œ˙1.Are you willing to travel away from home for:‚˙˙˙Q1á1‚„˙ Œ˙ A. 1 to 5 nights each month?‚˙˙˙gČ1iČ1‚„˙  ‚˙˙Qß1ą2‚„˙ Œ˙!B. 6 to 10 nights each month?‚˙˙˙g›2i›2‚„˙  ‚˙˙Q´2†3‚„˙ Œ˙$!C. 11 or more nights each month?‚˙˙˙A¤3i¤3‚„˙  ‚˙˙Óƒ3^4‚„˙ ‚˙‚ ˙˙˙ńy3[x4‚„˙ ˙˙˙Č˙+(MILITARY SERVICE AND VETERAN PREFERENCE‚˙˙˙î‡ ü)ü#‚„˙ Œ˙A>Were you discharged from the military service under honorable conditions? PyI(If your discharge was changed to "honorable" or "general" by a Discharge Review Board, answer "YES". If you received a clemency discharge, answered "NO".) If "NO", provide below the date and type of discharge you received.P˙I‚˙˙˙C*F .ü#‚Honorable_discharge„˙ ‚ C*0, .é"ü#BC*é"0,ť#‚Yes_honorable_discharge„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒť#„:8Click if you were discharged under honorable conditions.…†˙˙‡˙˙0,é" .ť#‚No_honorable_discharge„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒť#„ZXClick if you were not discharged under honorable conditions (enter date and type below).…†˙˙‡˙˙C*é"C*ü#‚„˙  ‚˙˙˙0,é"0,ü#‚„˙  ‚˙˙˙ .é" .ü#‚„˙  ‚˙˙˙C*é" .é"‚„˙  ‚˙˙˙C*ü# .ü#‚„˙  ‚˙˙˙˙CC*F C*é"‚„˙  ‚˙˙˙0,F 0,é"‚„˙  ‚˙˙˙ .F .é"‚„˙  ‚˙˙˙C*F .F ‚„˙  ‚˙˙˙C*F 0,é"‚„˙ Č˙YES‚Ĺ˙‚ ˙˙˙˙˙˙˙0,F .é"‚„˙ Č˙NO‚Ĺ˙‚ ˙˙˙˙˙˙˙˙NƒYes_honorable_dischargeƒNo_honorable_discharge˙˙˙ý÷#S*÷#‚„˙  ‚˙˙jf708‚Retire_maj_or_lt_com„˙ ‚ jJf708Bjf7J08‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ08„][Click if you have or you will retire at or above the rank of major or lieutenant commander.…†˙˙‡˙˙Jf708‚ Checked_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ08„ecClick if you have not or you will not retire at or above the rank of major or lieutenant commander.…†˙˙‡˙˙jf7j08‚„˙  ‚˙˙˙Jf7J08‚„˙  ‚˙˙˙f708‚„˙  ‚˙˙˙jf7f7‚„˙  ‚˙˙˙j0808‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ Checked_no˙˙˙3˝6™%8‚„˙ Œ˙‹ˆDid you or will you retire at or above the rank of major or lieutenant commander? . . . . . . . . . . . . . . . . . . . . . . . . . . .‚˙˙˙@.8h.8‚„˙  ‚˙˙;38"38‚„˙  ‚˙˙Ao8.ő9‚„˙ Œ˙b_THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER PREVIOUS EDITION USABLE UNTIL 12-31-90‚˙˙˙˛";žŠ<‚„˙ Œ˙PPage 1P˙‚˙˙˙™.f‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙]%.R‚„˙ Č˙DO NOT WRITE IN THIS AREA‚˙˙˙:‰ .—‚„˙ Č˙.+IFOR USE OF EXAMINING OFFICE ONLYI‚˙˙˙­.z‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙—.—‚„˙  ‚˙˙@.@‚„˙  ‚˙˙p°8 ‚‚„˙ Œ˙Date entered register‚˙˙˙˙ŚÇ&x‚„˙ Œ˙Form reviewed:‚˙˙˙ xČ&J‚„˙ Œ˙Form approved:‚˙˙˙ÔœÔ@‚„˙  ‚˙˙­Aý#Ě‚Preference_rating„˙ ‚­ ý#0 = ;ěĚB­0 = ‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚ƒ= …†˙˙‡˙˙­= ;‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚ ƒ;…†˙˙‡˙˙­;‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚!ƒ…†˙˙‡˙˙­ě‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚"ƒě…†˙˙‡˙˙­ěĚ‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚#ƒĚ…†˙˙‡˙˙0  = ‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚$ƒ= …†˙˙‡˙˙=  ;‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚%ƒ;…†˙˙‡˙˙; ‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚&ƒ…†˙˙‡˙˙ ě‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚'ƒě…†˙˙‡˙˙ě Ě‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚(ƒĚ…†˙˙‡˙˙ 0 ý#= ‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚)ƒ= …†˙˙‡˙˙ = ý#;‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚*ƒ;…†˙˙‡˙˙ ;ý#‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚+ƒ…†˙˙‡˙˙ ý#ě‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚,ƒě…†˙˙‡˙˙ ěý#Ě‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚-ƒĚ…†˙˙‡˙˙­0 ­Ě‚„˙ ‚˙˙˙0 Ě‚„˙ ‚˙˙˙ 0  Ě‚„˙ ‚˙˙˙ý#0 ý#Ě‚„˙ ‚˙˙˙­0 ý#0 ‚„˙ ‚˙˙˙­= ý#= ‚„˙ ‚˙˙˙­;ý#;‚„˙ ‚˙˙˙­ý#‚„˙ ‚˙˙˙­ěý#ě‚„˙ ‚˙˙˙­Ěý#Ě‚„˙ ‚˙˙˙˙C­A­0 ‚„˙ ‚˙˙˙A0 ‚„˙ ‚˙˙˙ A 0 ‚„˙ ‚˙˙˙ý#Aý#0 ‚„˙ ‚˙˙˙­Aý#A‚„˙ ‚˙˙˙­AÇ ‚„˙ Œ˙  Option‚˙˙˙‚ ˙˙˙˙˙˙˙A Ç ‚„˙ Œ˙  Grade‚˙˙˙‚ ˙˙˙˙˙˙˙ Aý#0 ‚„˙ Œ˙Earned Rating‚˙˙˙‚ ˙˙˙˙˙˙˙˙Nƒ OptionƒGradeƒEarned_rating˙˙˙˛e%.e‚„˙  ‚˙˙“ß[ Ď‚„˙ Œ˙P˘Initials and DateP˙‚˙˙˙’*A .Ě‚Augmented_rating„˙ ‚’* ./ < :ëĚB’*/ .< ‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚.ƒ< „97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*< .:‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚/ƒ:„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*: .‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚0ƒ„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’* .ë‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚1ƒë„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*ë .Ě‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚2ƒĚ„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*/ ’*Ě‚„˙  ‚˙˙˙ ./ .Ě‚„˙  ‚˙˙˙’*/ ./ ‚„˙  ‚˙˙˙’*< .< ‚„˙  ‚˙˙˙’*: .:‚„˙  ‚˙˙˙’* .‚„˙  ‚˙˙˙’*ë .ë‚„˙  ‚˙˙˙’*Ě .Ě‚„˙  ‚˙˙˙˙C’*A’*/ ‚„˙  ‚˙˙˙ .A ./ ‚„˙  ‚˙˙˙’*A .A‚„˙  ‚˙˙˙’*A .Ç ‚„˙ Œ˙Augmented Rating‚Ń˙‚ ˙˙˙˙˙˙˙˙NƒAugmented_rating_entries˙˙˙ $, œ*, ‚„˙  ‚˙˙~% ˜)? ‚„˙ Œ˙No Preference Claimed‚˙˙˙~%C ˜)‚„˙ Œ˙5 Points (Tentative)‚˙˙˙~%(=*č‚„˙ Œ˙%"10 Pts. (30% or More Comp. Dis.)‚˙˙˙~%÷y*}‚„˙ Œ˙&#10 Pts. (Less Than 30% Comp. Dis.)‚˙˙˙%ވ*™‚„˙ Œ˙Other 10 Points‚Ń˙%׈*Ć‚„˙ Œ˙ Disallowed‚Ń˙°%äŤ*Ó‚„˙ Œ˙Being Investigated‚Ń˙:j.ŕ‚„˙ Č˙żźIFOR USE OF APPOINTING OFFICE ONLY BIPŽPreference has been verified through proof that the separation was under honorable conditions, and other proof as required.BP˙‚˙˙˙˜ëÁř‚„˙ Œ˙ 5 Points‚Ń˙Ěě$T‚„˙ Œ˙.+10-Pt.- 30% or More Compensable Disability‚˙˙˙Ô$ě +Ź‚„˙ Œ˙0-10-Pt.- Less Than 30% Compensable Disability‚˙˙˙š+ě/.ť‚„˙ Œ˙10-Point- Other‚˙˙˙Ď„— t‚„˙ Œ˙!P˘Signature and TitleP˙‚˙˙˙˛x%.x‚„˙  ‚˙˙Ď‘— c‚„˙ Œ˙ Agency‚˙˙˙6&‘ţ,c‚„˙ Œ˙Date‚˙˙˙&&ˇ‚„˙  ‚˙˙î÷#.@&‚Non_honorable_discharge„˙ ‚ îů#.f%@&Bîf%ů#@&‚Discharge_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚>ƒ@&„YWIf your discharge was not under honorable conditions, enter the date of your discharge.…†˙˙‡˙˙ů#f%.@&‚Discharge_type„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚?ƒ@&„a_If your discharge was not under honorable conditions, enter the type of discharge you received.…†˙˙‡˙˙îf%î@&‚„˙ ‚˙˙˙ů#f%ů#@&‚„˙ ‚˙˙˙.f%.@&‚„˙ ‚˙˙˙îf%.f%‚„˙ ‚˙˙˙î@&.@&‚„˙ ‚˙˙˙˙Cî÷#îf%‚„˙ ‚˙˙˙ů#÷#ů#f%‚„˙ ‚˙˙˙.÷#.f%‚„˙ ‚˙˙˙î÷#.÷#‚„˙ ‚˙˙˙î÷#ů#f%‚„˙ Œ˙'$Discharge Date ( Month, Day, Year )‚˙˙˙‚ ˙˙˙˙˙˙˙ů#÷#.f%‚„˙ Œ˙Type of Discharge‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒDischarge_dateƒDischarge_type˙˙˙îw&ˇ-I'‚„˙ Œ˙OLList the dates (Month, Day, Year ), and branch for all active duty military‚˙˙˙ó?'ó--*‚Active_duty_dates„˙  ‚ó$ó-R(B)-*BóR(ÂB)‚From_active_dates„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚@ƒB)„<:Enter the begining dates for your active military service.…†˙˙‡˙˙óB)Â-*‚From_active_dates„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚Aƒ-*„<:Enter the begining dates for your active military service.…†˙˙‡˙˙ÂR($B)‚Ending_active_duty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚BƒB)„:8Enter the ending dates for your active military service.…†˙˙‡˙˙ÂB)$-*‚Ending_active_duty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚Cƒ-*„:8Enter the ending dates for your active military service.…†˙˙‡˙˙$R(ó-B)‚Branch_of_service„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚DƒB)„;9Enter the branch(es) of the military in which you served.…†˙˙‡˙˙$B)ó--*‚Branch_of_service„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚Eƒ-*„;9Enter the branch(es) of the military in which you served.…†˙˙‡˙˙óR(ó-*‚„˙  ‚˙˙˙ÂR(Â-*‚„˙ ‚˙˙˙$R($-*‚„˙ ‚˙˙˙ó-R(ó--*‚„˙  ‚˙˙˙óR(ó-R(‚„˙ ‚˙˙˙óB)ó-B)‚„˙  ‚˙˙˙ó-*ó--*‚„˙  ‚˙˙˙˙Có?'óR(‚„˙  ‚˙˙˙Â?'ÂR(‚„˙ ‚˙˙˙$?'$R(‚„˙ ‚˙˙˙ó-?'ó-R(‚„˙  ‚˙˙˙ó?'ó-?'‚„˙  ‚˙˙˙ó?'ÂR(‚„˙ Œ˙From‚˙˙‚ ˙˙˙˙˙˙˙Â?'$R(‚„˙ Œ˙To‚˙˙‚ ˙˙˙˙˙˙˙$?'ó-R(‚„˙ Œ˙Branch of Service‚˙˙‚ ˙˙˙˙˙˙˙˙NƒFrom_active_datesƒEnding_active_dutyƒBranch_of_service˙˙˙óP*ř-š+‚„˙ Œ˙ÁžPyIf all your active military duty was after October 14, 1976, list the full names and dates of all campaign badges or expeditionary medals you received or were entitled to receive.P˙‚˙˙˙óß,î-ß,‚„˙  ‚˙˙óř,ř-#/‚„˙ Œ˙ńîBRead the instructions that came with this form before completing this item. BWhen you have determined your eligibility for veteran preference from the instructions, place an "X" in the box next to your veteran preference claim.‚˙˙˙Kx/—*J0‚„˙ Œ˙NO PREFERENCE‚˙˙˙QO0™-5‚„˙ Œ˙ť¸5-POINT PREFERENCE -- You must show proof when you are hired. 10-POINT PREFERENCE -- If you claim 10-point preference, place an "X" in the box below next to the basis for your claim. BTo receive 10-point preference you must also complete a Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center. ATTACH THE COMPLETED SF 15 AND REQUESTED PROOF TO THIS APPLICATION.B‚˙˙˙K^5—*06‚„˙ Œ˙74Non-Compensably disabled or Purple Heart recipient.‚˙˙˙K&6—*ř6‚„˙ Œ˙/,Compensably disabled, less than 30 percent.‚˙˙˙Kř6Ł-Ę7‚„˙ Œ˙C@Spouse, widow(er), or mother of a deceased or disabled veteran.‚˙˙˙KÔ7Ł-Ś8‚„˙ Œ˙-*Compensably disabled, 30 percent or more.‚˙˙˙óÝ8ó-Ý8‚„˙ ‚˙˙ 9î-D;‚„˙ Œ˙a^Standard Form B171B # (Rev. 6-88) U.S. Office of Personnel Management FPM Chapter 295‚˙˙˙ž.€‚„˙  ˙# Form Approved OMB No. 3206-0012‚˙˙˙ …2t‚„˙ Œ˙ Temporary‚Ń˙Ă…ůt‚„˙ Œ˙Career-Conditional‚Ń˙­…2e‚„˙ Œ˙ Career‚Ń˙Ÿ‰x‚„˙ Œ˙ Excepted‚Ń˙Ułk Đ ‚Applicant_ssnƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚OƒĐ „USEnter your Social Security Number (SSN). Press to advance to the next field.…†˙˙‡˙U k Ť ‚Applicant_birthdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyyyƒ˙˙‚PƒŤ „B@Enter your birthdate. Press to advance to the next field.…†˙˙‡˙FO Řl‚Applicant_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Qƒl„ljEnter your name. Use a comma to separate your last name, first name, and middile initial (if applicable).…†˙˙‡˙f71‚Applicant_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Sƒ1„MKUsing all capital letters, enter the two-letter abbreviation of your state.…†˙˙‡˙A1‚Applicant_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Tƒ1„Enter your zip code.…†˙˙‡˙U ç=‚Appliant_aliasƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Uƒ=„nlEnter any other names (aliases) that you have ever used. Common aliases include maiden names and nicknames.…†˙˙‡˙6‘莂Home_area_codeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚VƒŽ…†˙˙‡˙n ‘LŽ‚Work_area_codeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚WƒŽ…†˙˙‡˙q‘AŽ‚Work_extensionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚XƒŽ…†˙˙‡˙>‘V Ž‚Home_phone_numberƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚YƒŽ…†˙˙‡˙„‘5Ž‚Work_phone_numberƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ZƒŽ…†˙˙‡˙F>Řj‚Applicant_addressƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚[ƒj„A?Enter your mailing address. Include apartment numbers, if any.…†˙˙‡˙ irY‚ Temporary„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚\ƒY„ECClick if you were ever employed as a temporary government employee.…†˙˙‡˙lé\‚ Career„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚]ƒ\„PNClick if you were ever employed as a government employee in a career position.…†˙˙‡˙xlŕ\‚ Excepted„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚^ƒ\„SQClick if you were ever employed as a government employee in an excepted position.…†˙˙‡˙Śl \‚Career_conditional„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚_ƒ\„\ZClick if you were ever employed as a government employee in a career-conditional position.…†˙˙‡˙Ź ?\\‚Highest_grade_fromƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚aƒ\…†˙˙‡˙KNű\‚Highest_grade_toƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚bƒ\…†˙˙‡˙iD"C C#‚Available_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚cƒC#„OMEnter the date (the month and year) that you will be available to start work.…†˙˙‡˙A D"˜B#‚ Lowest_payƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚dƒB#…†˙˙‡˙ÄD"YR#‚Lowest_pay_timeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚eƒR#„›Enter the time period for the pay amount listed. Use a two-letter abbreviation (e.g., "hr" for hour,"bi" for bi-weekly, "mo" for month, or "yr" for year).…†˙˙‡˙B"|R#‚ Lowest_gradeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚fƒR#…†˙˙‡˙UQ$çš&‚Geographic_areasƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚gƒš&…†˙˙‡˙j_4˘6‚Military_service„˙  ‚ jLÇ5˘6BjÇ5L™6‚ Yes_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚hƒ™6„—•Check if you have served in the United States Military Service. If your only active duty was training in the Reserves or National Guard answer "NO".…†˙˙‡˙˙LÇ5™6‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ý˙˙˙ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ Ą˘Ł¤ĽŚ§¨ŠŞŤŹ­ŽŻ°ą˛ł´ľśˇ¸šşťź˝žżŔÁÂĂÄĹĆÇČÉĘËĚÍÎĎĐŃŇÓÔŐÖ×ŘŮÚŰÜÝŢßŕáâăäĺćçčéęëěíîďđńňóôőö÷řůúűüýţ˙‚ƒ˙˙‚iƒ™6„ĆÄCheck if you have not served in the United States Military Service. If your only active duty was training in the Reserves or National Guard answer "NO". If you check "NO" go directly to item 22.…†˙˙‡˙˙jÇ5j˘6‚„˙  ‚˙˙˙LÇ5L˘6‚„˙  ‚˙˙˙Ç5˘6‚„˙  ‚˙˙˙jÇ5Ç5‚„˙  ‚˙˙˙j˘6˘6‚„˙  ‚˙˙˙˙Cj_4jÇ5‚„˙  ‚˙˙˙L_4LÇ5‚„˙  ‚˙˙˙_4Ç5‚„˙  ‚˙˙˙j_4_4‚„˙  ‚˙˙˙j_4LÇ5‚„˙ Č˙Yes‚˙‚ ˙˙˙˙˙˙˙L_4Ç5‚„˙ Č˙No‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Yes_checkedƒ No_checked˙˙˙3s4@­6‚„˙ Œ˙ť¸Have you served in the United States Military Service? If your only active duty was training in the Reserves or National Guard answer "NO". IfB "NO"B, go to item 22. . . . . .‚˙˙˙@ž6hž6‚„˙  ‚˙˙Ć_u1‚Date_entered_registerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyyyƒ˙˙‚jƒ1„@>Enter the date this application was entered into the register.…†˙˙‡˙:ý )‚Person_checkingƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚kƒ)„ Enter the reviewer's initials.…†˙˙‡˙6 ýp$)‚Initial_datesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚lƒ)„.,Enter the date that this form was initialed.…†˙˙‡˙ QÁ-n‚Signature_and_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚mƒn„B@Enter the signature and title of the preference verifying party.…†˙˙‡˙ mœ%{‚ Agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚nƒ{…†˙˙‡˙đ&m­-Š‚Date_of_preferenceƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚oƒŠ…†˙˙‡˙%•+ˇ-Đ,‚Badgesandmedalsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚pƒĐ,„ľłIf all your active military duty was after October 14, 1976, list the full names and dates of all campaign badges or expeditionary medals you received or were entitled to receive.…†˙˙‡˙QuŒ’‚„˙ Œ˙ Pň1P˙‚˙˙˙QÜŒ ‚„˙ Œ˙ Pň2P˙‚˙˙˙L ܇  ‚„˙ Œ˙ Pň3P˙‚˙˙˙L î ‡ ) ‚„˙ Œ˙ Pň5P˙‚˙˙˙ î KŔ ‚„˙ Œ˙+(Birthplace (City and State or Country)‚˙˙˙J ˘ ذ ‚Applicant_birthplaceƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚qƒ° „ŽŒEnter your the city and state of your birth, or country of your birth (if you were foreign-born). Press to advance to the next field.…†˙˙‡˙Qî Œ) ‚„˙ Œ˙ Pň4P˙‚˙˙˙Q› ŒÖ ‚„˙ Œ˙ Pň6P˙‚˙˙˙Q&Œa‚„˙ Œ˙ Pň7P˙‚˙˙˙Q`Œ›‚„˙ Œ˙ Pň8P˙‚˙˙˙f `Ą ›‚„˙ Œ˙ Pň9P˙‚˙˙˙ăU ­"‚„˙ Œ˙ Pň11P˙‚˙˙˙ăÖ‚„˙ Œ˙ Pň10P˙‚˙˙˙ U M ­"‚„˙ Œ˙ Pň12P˙‚˙˙˙ă“#ë%‚„˙ Œ˙ Pň13P˙‚˙˙˙ă¸&)‚„˙ Œ˙ Pň14P˙‚˙˙˙ăî,F/‚„˙ Œ˙ Pň15P˙‚˙˙˙ă60Ž2‚„˙ Œ˙ Pň16P˙‚˙˙˙ă´4 7‚„˙ Œ˙ Pň17P˙‚˙˙˙ăó6K9‚„˙ Œ˙ Pň18P˙‚˙˙˙•‡ Đß"‚„˙ đ˙19‚˙˙˙•Y&Đą(‚„˙ đ˙20‚˙˙˙•P*Đ|+‚„˙ đ˙21‚˙˙˙•ý,Đ .‚„˙ đ˙22‚˙˙˙ńˆ \‚„˙ ˙˙˙Č˙GENERAL INFORMATION‚˙˙˙RĚ-žž.‚„˙ Œ˙)&A. 5 to 12 months (Sometimes longer)?‚˙˙˙& "Ě‚ Job_typeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚}ƒĚ„ˇľEnter a general description of the kind of job you are applying for. If available, provide the title and announcement number for the job. Press to advance to the next field.…†˙˙‡˙ěˇqŚ ‚„˙  ˙Male‚Ń˙ŢťĚŞ ‚„˙  ˙ Female‚Ń˙!‚„˙)ŔžŽŽ ‚Applicant_gender_male„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Ü˙‚ƒ˙˙‚~ƒŽ „ecCheck the appropriate box. You cannot check both boxes. Press to advance to the next field.…†˙˙‡˙ˇžŽ ‚Applicant_gender_female„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚ƒŽ „ecCheck the appropriate box. You cannot check both boxes. Press to advance to the next field.…†˙˙‡˙˙˙!‚„˙)R$m ş%+ ‚No_preference_claimed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚3ƒ+ „64Click if the applicant did not claim any preference.…†˙˙‡˙R$1 ş%ď ‚Five_points_claimed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚4ƒď „-+Click if the applicant claimed five points.…†˙˙‡˙R$ş%Ň‚Ten_points_plus_30_percent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚5ƒŇ„_]Click if the applicant claimed ten preference points with 30% or more compensable disability.…†˙˙‡˙R$íş%Ť‚" Ten_points_less_than_30_percent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚6ƒŤ„a_Click if the applicant claimed ten preference points with less than 30% compensable disability.…†˙˙‡˙a$ŻÉ%m‚Other_ten_points„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚7ƒm„USClick if the applicant claimed an "other" 10 point preference for any other reason.…†˙˙‡˙a$ŃÉ%‚ Disallowed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚8ƒ„53Click if the applicant's preference was disallowed.…†˙˙‡˙k$äÓ%˘‚Being_investigated„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚9ƒ˘„HFClick if the applicant's preferences are currently being investigated.…†˙˙‡˙˙˙!‚„˙)™Ďż‚Five_point_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚:ƒż„NLClick here if five point preference has been verified by all required proof.…†˙˙‡˙×Ń?Á‚Ten_point_plus_30_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚;ƒÁ„wuClick here if ten point preference (with 30% or more compensable disability) has been verified by all required proof.…†˙˙‡˙Ő#Ń=%Á‚Ten_point_less_30_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚<ƒÁ„ywClick here if ten point preference (with less than 30% compensable disability) has been verified by all required proof.…†˙˙‡˙ľ*Ń,Á‚Ten_point_other_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚=ƒÁ„XVClick here if an "other" ten point preference has been verified by all required proof.…†˙˙‡˙˙˙!‚„˙)âĆ5v¸6‚Disabled_compless30„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚†ƒ¸6…†˙˙‡˙âÖ4vČ5‚Disabled_noncomp„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚‡ƒČ5…†˙˙‡˙âŞ6vœ7‚ Spouse„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚Œƒœ7…†˙˙‡˙â˜7vŠ8‚Disabled_compmore30„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚ƒŠ8…†˙˙‡˙ŕú/tě0‚Preference_5point„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚„ƒě0…†˙˙‡˙ŕ /tü/‚Preference_none„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚…ƒü/…†˙˙‡˙˙˙œ#'8+‚Job2_employerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚^ƒ+…†˙˙‡˙œ 8n‚Job1_employerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚tƒn„{yEnter your most recent employer's address. Press to begin a new line. Press to advance to the next field.…†˙˙‡˙bó%”‚„˙ Œ˙May we ask your present employer about your character, qualifications, and work record? A "NO" will not affect our review of your qualifications. If you answer "NO" and we need to contact your present employer before we can offer you a job, we will contact you first............‚˙˙˙b E* ‚„˙  ‚˙˙)*ö. ‚Contact_employer„˙  ‚ )* ,.ý B)*ý ,í‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚rƒí„64Click "Yes" if we may contact your current employer.…†˙˙‡˙˙ ,ý.í‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚sƒí„DBClick "No" if you do not want us to contact your current employer.…†˙˙‡˙˙)*ý)* ‚„˙  ‚˙˙˙ ,ý , ‚„˙  ‚˙˙˙.ý. ‚„˙  ‚˙˙˙)*ý.ý‚„˙  ‚˙˙˙)* . ‚„˙  ‚˙˙˙˙C)*ö)*ý‚„˙  ‚˙˙˙ ,ö ,ý‚„˙  ‚˙˙˙.ö.ý‚„˙  ‚˙˙˙)*ö.ö‚„˙  ‚˙˙˙)*ö ,ý‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙ ,ö.ý‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙q‚IS‚„˙ Œ˙HEREAD BWORK EXPERIENCEB IN THE INSTRUCTIONS BEFORE YOU BEGIN.‚˙˙˙4<9* ‚„˙ Œ˙1.Describe your current or most recent job in Block BAB and work backwards, describing each job you held Bduring the past 10 years.B If you were BunemployedB for longer than B3 monthsB within the past 10 years, list the dates and your address(es) in an experience block.‚˙˙˙4Œ 9Ć ‚„˙ Œ˙ŇĎYou may sum up in one block work that you did Bmore than 10 years ago.B But if that work Bis relatedB to the type of job you are applying for, describe each related job in a separate block.‚˙˙˙4j 9X‚„˙ Œ˙YVINCLUDE VOLUNTEER WORK ( non-paid work )-- BIf the workB ( or a part of the work )B is like the job you are applying for,B complete BallB parts of the experience block just as you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations.‚˙˙˙Ýyâ-g‚„˙ Œ˙ INCLUDE MILITARY SERVICE-- You should complete BallB parts of the experience block just as you would for a non-military job, including all supervisory experience. Describe each major change of duties or responsibilities in a separate experience block.‚˙˙˙ÜÁá-Ż ‚„˙ Œ˙IF YOU NEED MORE SPACE TO DESCRIBE A JOB-- Use sheets of paper the same size as this page (be sure to include all information we ask for in BAB and BB Bbelow). On BeachB sheet show your name, Social Security Number, and the announcement number or job title.‚˙˙˙ÜK á-Ń ‚„˙ Œ˙MJIF YOU NEED MORE EXPERIENCE BLOCKS, use the SF 171-A or a sheet of paper.‚˙˙˙Ý_â-ĺ‚„˙ Œ˙heIF YOU NEED TO UPDATE (ADD MORE RECENT JOBS), use the SF 172 or a sheet of paper as described above.‚˙˙˙q'.‚„˙ ‚˙˙7°Á‚„˙ Œ˙NKName and address of employer's organization ( include ZIP Code, if known )‚˙˙˙T+T‡‚„˙  ‚˙˙ry(.y‚„˙  ‚˙˙o+x!ď‚„˙ Œ˙74P˘P˙Dates employed (give month, day and year)‚˙˙˙č!+č!‡‚„˙  ‚˙˙ö!+(Á‚„˙ Œ˙$!Average number of hours per week‚˙˙˙˜'˜'…‚„˙  ‚˙˙´'+¸-ł‚„˙ Œ˙&#Number of employees you supervised‚˙˙˙bw(.w‚„˙ ‚˙˙~—Zi‚„˙ Œ˙ From:‚˙˙˙ä—Ŕi‚„˙ Œ˙To:‚˙˙˙o“x!e‚„˙ Œ˙Salary or earnings‚˙˙˙~s¸E‚„˙ Œ˙ Starting‚˙˙˙~}¸O‚„˙ Œ˙ Ending‚˙˙˙ sÚE‚„˙ Œ˙$‚˙˙˙ }ÚO‚„˙ Œ˙$‚˙˙˙Bs| E‚„˙ Œ˙per‚˙˙˙B}| O‚„˙ Œ˙per‚˙˙˙ö!“z+e‚„˙ Œ˙$!Your reason for wanting to leave‚˙˙˙rÓ(.Ó‚„˙  ‚˙˙•Ź g‚„˙ Œ˙Your immediate supervisor‚˙˙˙/~‚„˙ Œ˙Name‚˙˙˙Ž KŽ Ó‚„˙  ‚˙˙› /š‚„˙ Œ˙ Area Code‚˙˙˙t Kt Ó‚„˙  ‚˙˙ /œ‚„˙ Œ˙Telephone No.‚˙˙˙$y$á‚„˙  ‚˙˙1•^g‚„˙ Œ˙Exact title of your job‚˙˙˙:y:á‚„˙  ‚˙˙HÔ-ׂ„˙ Œ˙”‘PyIf Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotionP˙‚˙˙˙€íĆ-‚„˙  ˙PMDescription of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work ( for example, carpentry and painting, or personnel and budget ), write the approximate percentage of time you spent doing each.‚˙˙˙rŠ%(.Š%‚„˙ (‚˙˙˛+;ž“<‚„˙ Œ˙PPage 2P˙‚˙˙˙ [;.i<‚„˙ Č˙URIF YOU NEED MORE EXPERIENCE BLOCKS, USE SF 171 - A (SEE BACK OF INSTRUCTION PAGE)‚˙˙˙ţ.9T‚„˙ Œ˙ Pň23P˙‚˙˙˙ Žcě‚„˙ Œ˙ Pň24P˙‚˙˙˙!‚„˙)řQ‚„˙ ‚˙‚ ˙˙˙ Hy‚„˙ ˙˙˙Œ˙ PAP˙‚˙˙˙˙˙!‚„˙)ř%Ă&‚„˙ ‚˙‚ ˙˙˙ ƒ%Hë&‚„˙ ˙˙˙Œ˙ PBP˙‚˙˙˙˙˙0'ä`‚Job1_startdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚uƒ`„&$Enter the date you started this job.…†˙˙‡˙î'˘!`‚ Job1_enddateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚vƒ`„YWEnter the date which you left the job. If you are currently employed, enter "Present".…†˙˙‡˙X"‰ 'i‚ Job1_hoursƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚wƒi„0.Enter the number of hours per week you worked.…†˙˙‡˙x(‰,-i‚Job1_employeesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚xƒi„53Enter the total number of employees you supervised.…†˙˙‡˙HNü.‚Job1_startpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚yƒ.„:8Enter your salary at the time of starting this position.…†˙˙‡˙HEü%‚ Job1_endpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚zƒ%„97Enter your salary at the time of leaving this position.…†˙˙‡˙vE†!B‚ Job1_endperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚{ƒB„NLEnter the time period for the ending salary listed (hour, month, year, etc.)…†˙˙‡˙ "Hâ-\‚ Job1_reasonƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚|ƒ\…†˙˙‡˙€×€ ˇ‚ Job1_superƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚}ƒˇ…†˙˙‡˙Ş ×X ˇ‚Job1_areacodeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚~ƒˇ„@>Enter the area code of your immediate supervisor for this job.…†˙˙‡˙‚ ס‚ Job1_phoneƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒˇ„CAEnter the phone number of your immediate supervisor for this job.…†˙˙‡˙@С‚ Job1_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚€ƒˇ…†˙˙‡˙V× .ˇ‚ Job1_federalƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒˇ…†˙˙‡˙#•#.›%‚„˙ ‚˙‚ ˙˙˙~#ą#-ƒ$‚„˙ Œ˙:7rgbFor Agency Use (skill codes, etc.)d˙‚˙˙˙ÔeV-A#‚Job1_descriptionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚‚ƒA#„ZXEnter a description of your work at this job. Press to advance to the next field.…†˙˙‡˙$u$.%‚ Job1_agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒƒ%„KIEnter any specific codes (for indexing, validating, etc.) for the agency.…†˙˙‡˙ľ%°?'‚„˙ Œ˙NKName and address of employer's organization ( include ZIP Code, if known )‚˙˙˙TŠ%T+‚„˙  ‚˙˙r+(.+‚„˙  ‚˙˙oˇ%x!{&‚„˙ Œ˙74P˘P˙Dates employed (give month, day and year)‚˙˙˙č!Š%č!+‚„˙  ‚˙˙ö!ˇ%(M'‚„˙ Œ˙$!Average number of hours per week‚˙˙˙˜'›%˜'(‚„˙  ‚˙˙´'ˇ%¸-R'‚„˙ Œ˙&#Number of employees you supervised‚˙˙˙b((.(‚„˙ ‚˙˙~'Zç'‚„˙ Œ˙ From:‚˙˙˙ä'Ŕç'‚„˙ Œ˙To:‚˙˙˙o(x!ă(‚„˙ Œ˙Salary or earnings‚˙˙˙~ń(¸Ă)‚„˙ Œ˙ Starting‚˙˙˙~ű)¸Í*‚„˙ Œ˙ Ending‚˙˙˙ ń(ÚĂ)‚„˙ Œ˙$‚˙˙˙ ű)ÚÍ*‚„˙ Œ˙$‚˙˙˙Bń(| Ă)‚„˙ Œ˙per‚˙˙˙Bű)| Í*‚„˙ Œ˙per‚˙˙˙ö!(z+ă(‚„˙ Œ˙$!Your reason for wanting to leave‚˙˙˙r_-(._-‚„˙  ‚˙˙+Ź ĺ+‚„˙ Œ˙Your immediate supervisor‚˙˙˙­+~,‚„˙ Œ˙Name‚˙˙˙Ž Ü+Ž d-‚„˙  ‚˙˙ ­+Œ,‚„˙ Œ˙ Area Code‚˙˙˙‚ Ü+‚ d-‚„˙  ‚˙˙ ­+œ,‚„˙ Œ˙Telephone No.‚˙˙˙$+$_-‚„˙  ‚˙˙1+^ĺ+‚„˙ Œ˙Exact title of your job‚˙˙˙: +:_-‚„˙  ‚˙˙H +Ô-U,‚„˙ Œ˙”‘PyIf Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotionP˙‚˙˙˙€k-Ć-˙/‚„˙  ˙PMDescription of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work ( for example, carpentry and painting, or personnel and budget ), write the approximate percentage of time you spent doing each.‚˙˙˙r'; .';‚„˙ (‚˙˙#9. ;‚„˙ ‚˙‚ ˙˙˙€#9-ĺ9‚„˙ Œ˙:7rgbFor Agency Use (skill codes, etc.)d˙‚˙˙˙vN†!.‚Job1_startperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚”ƒ.„PNEnter the time period for the starting salary listed (hour, month, year, etc.)…†˙˙‡˙0ô&äă'‚Job2_startdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚_ƒă'„&$Enter the date you started this job.…†˙˙‡˙îä&˘!ă'‚ Job2_enddateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚`ƒă'„(&Enter the date which you left the job.…†˙˙‡˙X" ' 'ě'‚ Job2_hoursƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚aƒě'„0.Enter the number of hours per week you worked.…†˙˙‡˙x( ',-ě'‚Job2_employeesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚bƒě'„53Enter the total number of employees you supervised.…†˙˙‡˙€d,€ D-‚ Job2_superƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚gƒD-…†˙˙‡˙ś d,d D-‚Job2_areacodeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚hƒD-„@>Enter the area code of your immediate supervisor for this job.…†˙˙‡˙‚ d,D-‚ Job2_phoneƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚iƒD-„CAEnter the phone number of your immediate supervisor for this job.…†˙˙‡˙0\,D-‚ Job2_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚jƒD-…†˙˙‡˙V6, .4-‚ Job2_federalƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚kƒ4-…†˙˙‡˙Ôč/V-Ä8‚Description_of_work_2ƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚lƒÄ8„ZXEnter a description of your work at this job. Press to advance to the next field.…†˙˙‡˙$ř9.;‚ Job2_agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚mƒ;„KIEnter any specific codes (for indexing, validating, etc.) for the agency.…†˙˙‡˙Hß(üż)‚Job2_startpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚oƒż)„:8Enter your salary at the time of starting this position.…†˙˙‡˙HÖ)üś*‚ Job2_endpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚pƒś*„97Enter your salary at the time of leaving this position.…†˙˙‡˙vÖ)†!â*‚ Job2_endperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚qƒâ*„NLEnter the time period for the ending salary listed (hour, month, year, etc.)…†˙˙‡˙ "Ř(â-ě*‚ Job2_reasonƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚rƒě*…†˙˙‡˙vß(†!ż)‚Job2_startperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚sƒż)„PNEnter the time period for the starting salary listed (hour, month, year, etc.)…†˙˙‡˙!‚„˙)¸â'.ç‚„˙ ‚˙‚ ˙˙˙Çěœ,Ü‚„˙ ˙˙˙Č˙c`WORK EXPERIENCE If you have no work experience, write "NONE" in A below and go to 25 on page 3.‚˙˙˙˙˙¨6ţ-.‚ High_schoolƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ.…†˙˙‡˙7ˆ,…¤.‚„˙ Œ˙îëDo you speak or read a language other than EnglishI (include sign language)I? BIApplicants for jobs that require a language other than English may be given an interview conducted solely in that language.BI‚˙˙˙˛ˇ!.ź‚„˙ ‚˙‚ ˙˙˙¸ł!ł‚„˙ ˙˙˙Č˙ EDUCATION‚˙˙˙<ŇŚ!¨‚„˙ Č˙*'ATTACH ANY ADDITIONAL FORMS AND SHEETS‚˙˙˙FFě F‚„˙ (‚˙”ě FFF˙č×n‚„˙ Œ˙–“Did you graduate from high school? If you have a GED high school equivalency or will graduate within the next nine months, answer B"YES".B‚˙˙˙[ @y#F‚Attend_college„˙ ‚ ÷!y#@AFB÷!@y#ĺ‚Attended_college„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚–ƒĺ„ЧClick "YES" if you have attended a college or graduate school, and go to item 28. Click "NO" if you have not attended a college or graduate school, and go to item 31.…†˙˙‡˙˙÷!Ay#ć‚Attended_college„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚—ƒć„ЧClick "YES" if you have attended a college or graduate school, and go to item 28. Click "NO" if you have not attended a college or graduate school, and go to item 31.…†˙˙‡˙˙÷!@÷!F‚„˙  ‚˙˙˙y#@y#F‚„˙  ‚˙˙˙÷!@y#@‚„˙  ‚˙˙˙÷!Ay#A‚„˙  ‚˙˙˙÷!Fy#F‚„˙  ‚˙˙˙˙R[ @÷!@‚„˙  ‚˙˙˙[ A÷!A‚„˙  ‚˙˙˙[ F÷!F‚„˙  ‚˙˙˙[ @[ F‚„˙  ‚˙˙˙[ @÷!A‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙[ A÷!F‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙NƒAttended_college˙˙˙‡śÝ!‚„˙ Œ˙ROIfB "YES",B give month and year graduated or received GED equivalency:‚™˙‡šä‚„˙ Œ˙<9IfB "NO",B give the highest grade you completed:‚™˙šč -`‚„˙ Œ˙ŒWrite the name and location ( city and state ) of the last high school you attended or where you obtained your GED high school equivalency.‚˙˙˙™@ .@‚„˙  ‚˙˙—zÝ‚„˙ Œ˙63Have you ever attended college or graduate school?‚˙˙˙ĐšČ‚ Hs_grad„˙ ‚ ĄšĐĚČBĄĐšu‚ Yes_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚˜ƒu„}If you graduated from high school, will graduate in the next nine months, or have a GED, click "YES". Otherwise, click "NO".…†˙˙‡˙˙ĄĚšq‚ Yes_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚™ƒq„}If you graduated from high school, will graduate in the next nine months, or have a GED, click "YES". Otherwise, click "NO".…†˙˙‡˙˙ĄĐĄČ‚„˙  ‚˙˙˙šĐšČ‚„˙  ‚˙˙˙ĄĐšĐ‚„˙  ‚˙˙˙ĄĚšĚ‚„˙  ‚˙˙˙ĄČšČ‚„˙  ‚˙˙˙˙RĐĄĐ‚„˙  ‚˙˙˙ĚĄĚ‚„˙  ‚˙˙˙ČĄČ‚„˙  ‚˙˙˙ĐČ‚„˙  ‚˙˙˙ĐĄĚ‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙ĚĄČ‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙Nƒ Yes_no˙˙˙K$jˇ,<‚„˙ Œ˙30IfB "YES",B continue withB 28.B‚™˙K$Xy**‚„˙ Œ˙*'IfB "NO", Bgo toB 31.B‚™˙óŽóD‚„˙ ‚˙˙F.F‚„˙ ‚˙˙˘ !.Ä‚Colleges_attended„˙ ‚ŰÇ…™łöK"Ď$S'í*!.˘ X ÄBŰ˘ ÇX ‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚šƒX „/-Enter the names of any colleges you attended.…†‡˙˙ŰX Ç‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚›ƒ„/-Enter the names of any colleges you attended.…†‡˙˙ŰÇÄ‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚œƒÄ„/-Enter the names of any colleges you attended.…†‡˙˙Ç˘ …X ‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒX „Enter the college's city.…†‡˙˙ÇX …‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚žƒ„Enter the college's city.…†‡˙˙Ç…Ä‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŸƒÄ„Enter the college's city.…†‡˙˙…˘ ™X ‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ ƒX „Enter the college's state.…†‡˙˙…X ™‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ąƒ„Enter the college's state.…†‡˙˙…™Ä‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˘ƒÄ„Enter the college's state.…†‡˙˙™˘ łX ‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚كX „Enter the college's zip code.…†‡˙˙™X ł‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¤ƒ„Enter the college's zip code.…†‡˙˙™łÄ‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ĽƒÄ„Enter the college's zip code.…†‡˙˙ł˘ öX ‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ڃX „31Enter the date you started attending the college.…† ‡˙˙łX ö‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚§ƒ„31Enter the date you started attending the college.…† ‡˙˙łöÄ‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¨ƒÄ„31Enter the date you started attending the college.…† ‡˙˙ö˘ K"X ‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ЃX „<:Enter the date on which you stopped attending the college.…† ‡˙˙öX K"‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ރ„<:Enter the date on which you stopped attending the college.…† ‡˙˙öK"Ä‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŤƒÄ„<:Enter the date on which you stopped attending the college.…† ‡˙˙K"˘ Ď$X ‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ʃX „:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙K"X Ď$‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚­ƒ„:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙K"Ď$Ä‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ރÄ„:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙Ď$˘ S'X ‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚݃X „53Enter the number of quarter credit hours completed.…†˙˙‡˙˙Ď$X S'‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚°ƒ„53Enter the number of quarter credit hours completed.…†˙˙‡˙˙Ď$S'Ä‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ąƒÄ„53Enter the number of quarter credit hours completed.…†˙˙‡˙˙S'˘ í*X ‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˛ƒX „><Enter the type of degree program in which you were enrolled.…†‡˙˙S'X í*‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚łƒ„><Enter the type of degree program in which you were enrolled.…†‡˙˙S'í*Ä‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚´ƒÄ„><Enter the type of degree program in which you were enrolled.…†‡˙˙í*˘ !.X ‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ľƒX „86Enter the month and year that you received the degree.…†‡˙˙í*X !.‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚śƒ„86Enter the month and year that you received the degree.…†‡˙˙í*!.Ä‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ˇƒÄ„86Enter the month and year that you received the degree.…†‡˙˙Ű˘ ŰÄ‚„˙  ‚˙˙˙Ç˘ ÇÄ‚„˙  ‚˙˙˙…˘ …Ä‚„˙  ‚˙˙˙™˘ ™Ä‚„˙  ‚˙˙˙ł˘ łÄ‚„˙  ‚˙˙˙ö˘ öÄ‚„˙  ‚˙˙˙K"˘ K"Ä‚„˙  ‚˙˙˙Ď$˘ Ď$Ä‚„˙  ‚˙˙˙S'˘ S'Ä‚„˙  ‚˙˙˙í*˘ í*Ä‚„˙  ‚˙˙˙!.˘ !.Ä‚„˙  ‚˙˙˙Ű˘ !.˘ ‚„˙  ‚˙˙˙ŰX !.X ‚„˙  ‚˙˙˙Ű!.‚„˙  ‚˙˙˙ŰÄ!.Ä‚„˙  ‚˙˙˙˙R˘ ۢ ‚„˙  ‚˙˙˙X ŰX ‚„˙  ‚˙˙˙Ű‚„˙  ‚˙˙˙ÄŰÄ‚„˙  ‚˙˙˙˘ Ä‚„˙  ‚˙˙˙˘ ŰX ‚„˙  ˙1)‚Œ˙‚ ˙˙˙˙˙˙˙X Ű‚„˙  ˙2)‚‹˙‚ ˙˙˙˙˙˙˙ŰÄ‚„˙  ˙3)‚‹˙‚ ˙˙˙˙˙˙˙˙Nƒ College_nameƒ College_cityƒCollege_stateƒ College_zipƒCollege_startdateƒCollege_enddateƒCollege_semestersƒCollege_quartersƒCollege_degreeƒCollege_degreedate˙˙˙doę ‚„˙ Œ˙ľ˛NAME AND LOCATION ( city, state and ZIP Code ) OF COLLEGE OR UNIVERSITY. If you expect to graduate within nine months, give the month and year you expect to receive your degree:‚˙˙˙ę i'ę ‚„˙  ‚˙˙ř [Ž ‚„˙ Œ˙Name‚˙˙˙[ô ×Ć ‚„˙ Œ˙City‚˙˙˙Šô wĆ ‚„˙ Œ˙ State‚˙˙˙wô ÉĆ ‚„˙ Œ˙  ZIP Code‚˙˙˙ťô ëŽ ‚„˙ Œ˙From‚˙˙˙í$ř G'Ź ‚„˙ x˙ Quarter‚˙˙˙Áę Áź ‚„˙  ‚˙˙ę Ę ‚„˙  ‚˙˙“ę “Ę ‚„˙  ‚˙˙­F­Ř ‚„˙  ‚˙˙ůę ůĘ ‚„˙  ‚˙˙S"FS"ź ‚„˙  ‚˙˙['F['ź ‚„˙  ‚˙˙×$ę ×$Ę ‚„˙  ‚˙˙st™"ú ‚„˙ x˙MONTH AND YEAR ATTENDED‚˙˙˙E"tk'ž ‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙'u+d ‚„˙ x˙/,TYPE OF DEGREE I(e.g. B.A., M.A.)I‚˙˙˙é*Fé*ź ‚„˙  ‚˙˙ç*t#.T ‚„˙ x˙MONTH AND YEAR OF DEGREE‚˙˙˙˘Č†‚Chief_undergrad_subj„˙ ‚ŃđäȢ˜†BŃ˘đ˜‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¸ƒ˜„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Ń˜đ‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚šƒ„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Ńđ†‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚şƒ†„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙đ˘ä˜‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ťƒ˜„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙đ˜ä‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚źƒ„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙đä†‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚˝ƒ†„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙ä˘Č˜‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚žƒ˜„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙ä˜Č‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚żƒ„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙äČ†‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚Ŕƒ†„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙Ń˘Ń†‚„˙  ‚˙˙˙đ˘đ†‚„˙  ‚˙˙˙ä˘ä†‚„˙  ‚˙˙˙Č˘Č†‚„˙  ‚˙˙˙Ń˘Č˘‚„˙  ‚˙˙˙Ń˜Č˜‚„˙  ‚˙˙˙ŃČ‚„˙  ‚˙˙˙Ń†Č†‚„˙  ‚˙˙˙˙R˘Ń˘‚„˙  ‚˙˙˙˜Ń˜‚„˙  ‚˙˙˙Ń‚„˙  ‚˙˙˙†Ń†‚„˙  ‚˙˙˙˘†‚„˙  ‚˙˙˙˘Ń˜‚„˙  ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙˜Ń‚„˙  ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙Ń†‚„˙  ˙3)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ SubjectsƒSemester_hoursƒQuarter_hours˙˙˙ Óć‚„˙ x˙  Semester‚˙˙˙ňž˛‚„˙ x˙ Quarter‚˙˙˙ôÄôœ‚„˙  ‚˙˙ĹÄĹŚ‚„˙  ‚˙˙äţ䢂„˙  ‚˙˙=Ęc‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙öřÄř‚„˙  ‚˙˙ýţ„‚„˙ Œ˙GDCHIEF UNDERGRADUATE SUBJECTS IShow major on the first lineI‚˙˙˙x˘.†‚Chief_grad_subj„˙ ‚4Y(H+.˘˜†B4˘Y(˜‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Áƒ˜„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙4˜Y(‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒ„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙4Y(†‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Æ„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Y(˘H+˜‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ă˜„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙Y(˜H+‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚я„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙Y(H+†‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ƃ†„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙H+˘.˜‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ǃ˜„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙H+˜.‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ȃ„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙H+.†‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚Ƀ†„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙4˘4†‚„˙  ‚˙˙˙Y(˘Y(†‚„˙  ‚˙˙˙H+˘H+†‚„˙  ‚˙˙˙.˘.†‚„˙  ‚˙˙˙4˘.˘‚„˙  ‚˙˙˙4˜.˜‚„˙  ‚˙˙˙4.‚„˙  ‚˙˙˙4†.†‚„˙  ‚˙˙˙˙Rx˘4˘‚„˙  ‚˙˙˙x˜4˜‚„˙  ‚˙˙˙x4‚„˙  ‚˙˙˙x†4†‚„˙  ‚˙˙˙x˘x†‚„˙  ‚˙˙˙x˘4˜‚„˙  ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙x˜4‚„˙  ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙x4†‚„˙  ˙3)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ SubjectsƒSemester_hoursƒQuarter_hours˙˙˙_(A+ć‚„˙ x˙  Semester‚˙˙˙S+0.´‚„˙ x˙ Quarter‚˙˙˙X(ÄX(Ş‚„˙  ‚˙˙G+ţG+œ‚„˙  ‚˙˙›(ĘÁ-‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙\(ř!.ř‚„˙  ‚˙˙[ţe(„‚„˙ Œ˙B?CHIEF GRADUATE SUBJECTS IShow major on the first lineI‚˙˙˙'†!.†‚„˙  ‚˙˙'†0.ý‚„˙ Œ˙¸ľIf you have completed any Bother courses or training related to the kind of jobs you are applying for ( trade, vocational, Armed Forces, business ) give information below.B‚˙˙˙ä#.ä‚„˙  ‚˙˙'ş +ş‚„˙  ‚˙˙bq4‚„˙ Œ˙GDNAME AND LOCATION I( city, state, and ZIP Code ) IOF SCHOOL‚˙˙˙}  ę‚„˙ Œ˙From‚˙˙˙qňq΂„˙  ‚˙˙Î‚„˙  ‚˙˙ŁňŁŔ‚„˙  ‚˙˙}ÜŁ&‚„˙ x˙MONTH AND YEAR ATTENDED‚˙˙˙q Ł ‚„˙  ‚˙˙Mę_ę‚„˙ Œ˙Class Room Hours‚˙ďäďŔ‚„˙  ‚˙˙ýT‘+&‚„˙ Œ˙ Subject(s)‚˙˙˙+‘,ň‚„˙ Œ˙Yes‚˙˙˙+ě+Č‚„˙  ‚˙˙ , ,Č‚„˙  ‚˙˙#.ě#.ş‚„˙  ‚˙˙+ä.J‚„˙ x˙Training Completed‚˙˙˙ +.‚„˙  ‚˙˙qś!."‚Other_schools„˙ ‚q ¤î+Ą,!.śç$eÚ"Bqś ç‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ʃç„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qç $‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˃$„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙q$ e‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚̃e„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qe ‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚̓„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙q Ú‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚΃Ú„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qÚ "‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚σ"„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙ ś¤ç‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ѓç„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ ç¤$‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚у$„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ $¤e‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚҃e„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ e¤‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ӄ„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ ¤Ú‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ԃÚ„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ Ú¤"‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ճ"„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙¤śîç‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚փç„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤çî$‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚׃$„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤$îe‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚؃e„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤e Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ك„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤îÚ‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ڃÚ„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤Úî"‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ۃ"„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙îś+ç‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚܃ç„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îç+$‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚݃$„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙î$+e‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ރe„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îe+‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚߃„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙î+Ú‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŕƒÚ„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îÚ+"‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚áƒ"„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙+śĄ,ˆ‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚⃈„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+çĄ,š‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ăƒš„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+$Ą,ö‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚äƒö„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+eĄ,7‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ĺƒ7„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+Ą,o‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ćƒo„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+ÚĄ,Ź‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚çƒŹ„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙Ą,ś!.ˆ‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚čƒˆ„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,ç!.š‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚郚„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,$!.ö‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ęƒö„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,e!.7‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ëƒ7„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,!.o‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ěƒo„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,Ú!.Ź‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚íƒŹ„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙qśq"‚„˙  ‚˙˙˙ ś "‚„˙  ‚˙˙˙¤ś¤"‚„˙  ‚˙˙˙îśî"‚„˙  ‚˙˙˙+ś+"‚„˙  ‚˙˙˙Ą,śĄ,"‚„˙  ‚˙˙˙!.ś!."‚„˙  ‚˙˙˙qś!.ś‚„˙  ‚˙˙˙qç!.ç‚„˙  ‚˙˙˙q$!.$‚„˙  ‚˙˙˙qe!.e‚„˙  ‚˙˙˙q!.‚„˙  ‚˙˙˙qÚ!.Ú‚„˙  ‚˙˙˙q"!."‚„˙  ‚˙˙˙˙Nƒ Start_dateƒ End_dateƒ Class_hoursƒ SubjectsƒCompleted_yesƒ Completed_no˙˙˙€q€‚„˙  ‚˙˙Ŕ•v‚„˙ Œ˙1) School Name‚˙˙˙Ž•`‚„˙ Œ˙City‚˙˙˙ĹŽO`‚„˙ Œ˙ State‚˙˙˙ËŽG`‚„˙ Œ˙ Zip Code‚˙˙˙q€qj‚„˙  ‚˙˙jqj‚„˙  ‚˙˙Ą€Ąj‚„˙  ‚˙˙FqF‚„˙  ‚˙˙x•J‚„˙ Œ˙2) School Name‚˙˙˙T•&‚„˙ Œ˙City‚˙˙˙ĹTA&‚„˙ Œ˙ State‚˙˙˙ËTG&‚„˙ Œ˙ Zip Code‚˙˙˙qJq0‚„˙  ‚˙˙"q"‚„˙  ‚˙˙ĄLĄ"‚„˙  ‚˙˙´#. ‚„˙ ‚˙‚ ˙˙˙şż# ‚„˙ ˙˙˙Č˙.+SPECIAL SKILLS, ACCOMPLISHMENTS AND AWARDS‚˙˙˙ Ľ-X"‚„˙ Œ˙–“Give the title and year of any honors, awards or fellowships you have received. List your special qualifications, skills or accomplishments that may help you get a job. Some examples are: skills with computers or other machines; most important publications ( do not submit copies ); public speaking and writing experience; membership in professional or scientific societies; patents or inventions; etc.‚˙˙˙'§'1.§'‚„˙  ‚˙˙ś'm đ)‚„˙ Œ˙<9How many words per minute can you: TYPE? TAKE DICTATION?‚˙˙˙s ś'Ý-ˆ(‚„˙ Œ˙‡„List job-related licenses or certificates that you have, such as: registered nurse; lawyer; radio operator; driver's; pilot's; etc.‚˙˙˙!‚„˙)g %)!.ˆ,‚ Licenses„˙ ‚$ łß&!.›*‘+ˆ,B$ ›*ł‘+‚ License„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚+„/-Enter the name of the license or certificate.…†˙˙‡˙˙$ ‘+łˆ,‚ License„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ďƒˆ,„/-Enter the name of the license or certificate.…†˙˙‡˙˙ł›*ß&‘+‚ License_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ‚ dd/mm/yyyyƒ˙˙‚đƒ‘+„OMEnter the date of the awarding or last renewal of the license or certificate.…†˙˙‡˙˙ł‘+ß&ˆ,‚ License_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ‚ dd/mm/yyyyƒ˙˙‚ńƒˆ,„OMEnter the date of the awarding or last renewal of the license or certificate.…†˙˙‡˙˙ß&›*!.‘+‚License_agency„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ňƒ‘+„PNEnter the state or licensing agency which awarded this license or certificate.…†˙˙‡˙˙ß&‘+!.ˆ,‚License_agency„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚óƒˆ,„PNEnter the state or licensing agency which awarded this license or certificate.…†˙˙‡˙˙$ ›*$ ˆ,‚„˙  ‚˙˙˙ł›*łˆ,‚„˙  ‚˙˙˙ß&›*ß&ˆ,‚„˙  ‚˙˙˙!.›*!.ˆ,‚„˙  ‚˙˙˙$ ›*!.›*‚„˙  ‚˙˙˙$ ‘+!.‘+‚„˙  ‚˙˙˙$ ˆ,!.ˆ,‚„˙  ‚˙˙˙˙C$ %)$ ›*‚„˙ ‚˙˙˙ł%)ł›*‚„˙  ‚˙˙˙ß&%)ß&›*‚„˙  ‚˙˙˙!.%)!.›*‚„˙ ‚˙˙˙$ %)!.%)‚„˙  ‚˙˙˙$ %)ł›*‚„˙ Œ˙LICENSE OR CERTIFICATE‚˙‚ ˙˙˙˙˙˙˙ł%)ß&›*‚„˙ Œ˙*'DATE OF LATEST LICENSE OR CERTIFICATE‚˙˙˙‚ ˙˙˙˙˙˙˙ß&%)!.›*‚„˙ Œ˙$!STATE OR OTHER LICENSING AGENCY‚˙˙˙‚ ˙˙˙˙˙˙˙˙Rg ›*$ ›*‚„˙  ‚˙˙˙g ‘+$ ‘+‚„˙  ‚˙˙˙g ˆ,$ ˆ,‚„˙  ‚˙˙˙g ›*g ˆ,‚„˙  ‚˙˙˙g ›*$ ‘+‚„˙ Œ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙g ‘+$ ˆ,‚„˙ Œ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ Licenseƒ License_dateƒLicense_agency˙˙˙f ")T ")‚„˙  ‚˙˙˙˙ć*ý N,‚„˙ Œ˙41Agencies may test your skills before hiring you.‚˙˙˙ Â*ů Â*‚„˙  ‚˙˙ ^,ű ^,‚„˙  ‚˙˙ű Â*ű h,‚„˙  ‚˙˙Q–,‚˜.‚Other_language„˙ ‚ ö‚–,“-˜.Bö–,‚;-‚ Speak_read„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ôƒ;-„Ů×Do you speak or read another language (including sign language)? Click "YES" if you speak or read another language and list each language below. Click "NO" if you do not speak or read another language and go to 36.…†˙˙‡˙˙ö“-‚8.‚ Speak_read„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚őƒ8.„Ů×Do you speak or read another language (including sign language)? Click "YES" if you speak or read another language and list each language below. Click "NO" if you do not speak or read another language and go to 36.…†˙˙‡˙˙ö–,ö˜.‚„˙  ‚˙˙˙‚–,‚˜.‚„˙  ‚˙˙˙ö–,‚–,‚„˙  ‚˙˙˙ö“-‚“-‚„˙  ‚˙˙˙ö˜.‚˜.‚„˙  ‚˙˙˙˙RQ–,ö–,‚„˙  ‚˙˙˙Q“-ö“-‚„˙  ‚˙˙˙Q˜.ö˜.‚„˙  ‚˙˙˙Q–,Q˜.‚„˙  ‚˙˙˙Q–,ö“-‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙Q“-ö˜.‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙Nƒ Speak_read˙˙˙A–,0.Ř-‚„˙ Œ˙URIf "YES", list each language and place an "X" in each column that applies to you.‚™˙AŘ-o"Ş.‚„˙ Œ˙If "NO", go to 36.‚™˙x00.2‚Language_fluency„˙ ‚ĂůŁ#ą1 ż#L'Í*0.x0B12BĂx0ůB1‚ Language„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚öƒB1„omList other languages you speak or read fluently. Then check the boxes on the right relating to your fluency.…†˙˙‡˙˙ĂB1ů2‚ Language„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚÷ƒ2„omList other languages you speak or read fluently. Then check the boxes on the right relating to your fluency.…†˙˙‡˙˙ůx0Ł,1‚Lectures_fluent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚řƒ,1„GEClick if you can prepare and give lectures in this language fluently.…†˙˙‡˙˙ůB1Łö1‚Lectures_fluent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ůƒö1„GEClick if you can prepare and give lectures in this language fluently.…†˙˙‡˙˙Łx0#,1‚Lectures_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚úƒ,1„NLClick if you can prepare and give lectures in this language with difficulty.…†˙˙‡˙˙ŁB1#ö1‚Lectures_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚űƒö1„NLClick if you can prepare and give lectures in this language with difficulty.…†˙˙‡˙˙#x0ą,1‚Speak_fluently„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚üƒ,1„@>Click if you can speak and understand this language fluently.…†˙˙‡˙˙#B1ąö1‚Speak_fluently„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ýƒö1„@>Click if you can speak and understand this language fluently.…†˙˙‡˙˙ąx01 ,1‚Speak_passably„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ţƒ,1„@>Click if you can speak and understand this language passably.…†˙˙‡˙˙ąB11 ö1‚Speak_passably„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚˙ƒö1„@>Click if you can speak and understand this language passably.…†˙˙‡˙˙1 x0ż#,1‚ Into_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„=;Click if you can translate into english from this language.…†˙˙‡˙˙1 B1ż#ö1‚ Into_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„=;Click if you can translate into english from this language.…†˙˙‡˙˙ż#x0L',1‚ From_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„=;Click if you can translate from english into this language.…†˙˙‡˙˙ż#B1L'ö1‚ From_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„=;Click if you can translate from english into this language.…†˙˙‡˙˙L'x0Í*,1‚ Read_easily„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„JHClick if you can read articles in this language for your own use easily.…†˙˙‡˙˙L'B1Í*ö1‚ Read_easily„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„JHClick if you can read articles in this language for your own use easily.…†˙˙‡˙˙Í*x00.,1‚Read_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„SQClick if you can read articles in this language for your own use with difficulty.…†˙˙‡˙˙Í*B10.ö1‚Read_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„SQClick if you can read articles in this language for your own use with difficulty.…†˙˙‡˙˙Ăx0Ă2‚„˙  ‚˙˙˙ůx0ů2‚„˙  ‚˙˙˙Łx0Ł2‚„˙  ‚˙˙˙#x0#2‚„˙  ‚˙˙˙ąx0ą2‚„˙  ‚˙˙˙1 x01 2‚„˙  ‚˙˙˙ż#x0ż#2‚„˙  ‚˙˙˙L'x0L'2‚„˙  ‚˙˙˙Í*x0Í*2‚„˙  ‚˙˙˙0.x00.2‚„˙  ‚˙˙˙Ăx00.x0‚„˙  ‚˙˙˙ĂB10.B1‚„˙  ‚˙˙˙Ă20.2‚„˙  ‚˙˙˙˙Rx0Ăx0‚„˙  ‚˙˙˙B1ĂB1‚„˙  ‚˙˙˙2Ă2‚„˙  ‚˙˙˙x02‚„˙  ‚˙˙˙x0ĂB1‚„˙ Œ˙1)‚ť˙‚ ˙˙˙˙˙˙˙B1Ă2‚„˙ Œ˙2)‚ť˙‚ ˙˙˙˙˙˙˙˙Nƒ LanguageƒLectures_fluentƒLectures_difficultyƒSpeak_fluentlyƒSpeak_passablyƒ Into_englishƒ From_englishƒ Read_easilyƒRead_difficulty˙˙˙ œ.0.œ.‚„˙ ‚˙˙'p/ůN0‚„˙ Œ˙ LANGUAGE(S)‚˙˙˙Ř/0.Ř/‚„˙  ‚˙˙Ô/‡|0‚„˙ x˙  Fluently‚˙˙˙#˘.# 1‚„˙  ‚˙˙Łâ/ŁŹ0‚„˙  ‚˙˙1 ˘.1 1‚„˙  ‚˙˙M'œ.M' 1‚„˙  ‚˙˙´Ô/ˆ0‚„˙ x˙ With Difficulty‚˙˙˙Ś.đ/‚„˙ x˙!CAN PREPARE AND GIVE LECTURES‚˙˙˙ůš.ů1‚„˙  ‚˙˙?Ś. đ/‚„˙ x˙CAN SPEAK AND UNDERSTAND‚˙˙˙[Ô/‡Š0‚„˙ x˙  Fluently‚˙˙˙ąâ/ąž0‚„˙  ‚˙˙ŰÔ/ ˆ0‚„˙ x˙  Passably‚˙˙˙? Ô/Ł#Š0‚„˙ x˙ Into English‚˙˙˙ż#Ú/ż#ž0‚„˙  ‚˙˙Ű#Ô/?'ˆ0‚„˙ x˙ From English‚˙˙˙? Ś.?'đ/‚„˙ x˙CAN SPEAK AND UNDERSTAND‚˙˙˙i'Ô/ą*˜0‚„˙ x˙ Easily‚˙˙˙Í*Ü/Í*0‚„˙  ‚˙˙Ű*Ô/#.Š0‚„˙ x˙With Difficulty‚˙˙˙i'Ś.1.đ/‚„˙ x˙!CAN READ ARTICLES FOR OWN USE‚˙˙˙ 2c2‚„˙  ‚˙˙´ 2#.3‚„˙ ‚˙‚ ˙˙˙ş 2ż3‚„˙ ˙˙˙Č˙ REFERENCES‚˙˙˙3‰-œ4‚„˙ Œ˙ýList three people who are not related to you and are not supervisors you listed under B24B who know your qualifications and fitness for the kind of job for which you are applying. At least BoneB should know you well on a personal basis.‚˙˙˙4 .,;‚ References„˙ ‚_]&‹( .ý5Č7z9,;Bý5Č7‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ƒČ7„(&Enter the full name of your reference.…†˙˙‡˙˙Č7z9‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒz9„(&Enter the full name of your reference.…†˙˙‡˙˙z9,;‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒ,;„(&Enter the full name of your reference.…†˙˙‡˙˙ý5_Č7‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒČ7„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙Č7_z9‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒz9„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙z9_,;‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒ,;„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙_ý5]&Č7‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒČ7„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙_Č7]&z9‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒz9„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙_z9]&,;‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒ,;„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙]&ý5‹(Č7‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒČ7„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙]&Č7‹(z9‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒz9„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙]&z9‹(,;‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ,;„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙‹(ý5 .Č7‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒČ7„75Enter the zip code for the address of this reference.…†˙˙‡˙˙‹(Č7 .z9‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒz9„75Enter the zip code for the address of this reference.…†˙˙‡˙˙‹(z9 .,;‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ,;„75Enter the zip code for the address of this reference.…†˙˙‡˙˙ý5,;‚„˙  ‚˙˙˙ý5,;‚„˙  ‚˙˙˙_ý5_,;‚„˙  ‚˙˙˙]&ý5]&,;‚„˙  ‚˙˙˙‹(ý5‹(,;‚„˙  ‚˙˙˙ .ý5 .,;‚„˙  ‚˙˙˙ý5 .ý5‚„˙  ‚˙˙˙Č7 .Č7‚„˙  ‚˙˙˙z9 .z9‚„˙  ‚˙˙˙,; .,;‚„˙  ‚˙˙˙˙C4ý5‚„˙  ‚˙˙˙4ý5‚„˙  ‚˙˙˙_4_ý5‚„˙  ‚˙˙˙]&4]&ý5‚„˙  ‚˙˙˙‹(4‹(ý5‚„˙  ‚˙˙˙ .4 .ý5‚„˙  ‚˙˙˙4 .4‚„˙  ‚˙˙˙4ý5‚„˙ Œ˙FULL NAME OF REFERENCE‚˙˙‚ ˙˙˙˙˙˙˙4_ý5‚„˙ Œ˙-*TELEPHONE NUMBER(S) ( Include Area Code )‚“˙‚ ˙˙˙˙˙˙˙_4]&ý5‚„˙ Œ˙@=PRESENT BUSINESS OR HOME ADDRESS ( Number, street and city )‚“˙‚ ˙˙˙˙˙˙˙]&4‹(ý5‚„˙ Œ˙ STATE‚˙˙‚ ˙˙˙˙˙˙˙‹(4 .ý5‚„˙ Œ˙  ZIP CODE‚˙˙‚ ˙˙˙˙˙˙˙˙Rý5ý5‚„˙  ‚˙˙˙Č7Č7‚„˙  ‚˙˙˙z9z9‚„˙  ‚˙˙˙,;,;‚„˙  ‚˙˙˙ý5,;‚„˙  ‚˙˙˙ý5Č7‚„˙ Œ˙1)‚Œ˙‚ ˙˙˙˙˙˙˙Č7z9‚„˙ Œ˙2)‚Œ˙‚ ˙˙˙˙˙˙˙z9,;‚„˙ Œ˙3)‚Œ˙‚ ˙˙˙˙˙˙˙˙NƒNameƒPhoneƒ AddressƒStateƒZip˙˙˙˛&;ž|<‚„˙ Œ˙PPage 3P˙‚˙˙˙”4G”4‚„˙  ‚˙˙ ř A"’ ‚„˙ Œ˙To‚˙˙˙i"ř Ă$’ ‚„˙ x˙  Semester‚˙˙˙Ľ,!.ä‚„˙ Œ˙No‚˙˙˙ §Ü‚„˙ Œ˙To‚˙˙˙_n^j‚ School1_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒj„86Enter the name of the first other school you attended.…†˙˙‡˙_ZaV‚ School1_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒV„86Enter the city of the first other school you attended.…†˙˙‡˙Z‰T‚School1_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒT„97Enter the state of the first other school you attended.…†˙˙‡˙ˇZUR‚ School1_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒR„<:Enter the zip code of the first other school you attended.…†˙˙‡˙Az"ď-š'‚Skillsandawardsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ ƒš'…†˙˙‡˙+â)ŽŽ*‚ Typing_speedƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚!ƒŽ*„)'How many words per minute can you type?…†˙˙‡˙câ)ĺŽ*‚Dictation_speedsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚"ƒŽ*„" How fast can you take dictation?…†˙˙‡˙ŇĐ (‚„˙ Œ˙ Pň25P˙‚˙˙˙Îl Ä ‚„˙ Œ˙ Pň28P˙‚˙˙˙AĚ|$‚„˙ Œ˙ Pň26P˙‚˙˙˙>`y¸‚„˙ Œ˙ Pň27P˙‚˙˙˙Ń r‚„˙ Œ˙ Pň29P˙‚˙˙˙Sv‚„˙ Œ˙ Pň30P˙‚˙˙˙Đ¤ ü‚„˙ Œ˙ Pň31P˙‚˙˙˙Đ< ”"‚„˙ Œ˙ Pň32P˙‚˙˙˙Đœ' ô)‚„˙ Œ˙ Pň33P˙‚˙˙˙ú š'5 ň)‚„˙ Œ˙ Pň34P˙‚˙˙˙ĐŒ, ä.‚„˙ Œ˙ Pň35P˙‚˙˙˙Đ$3 |5‚„˙ Œ˙ Pň36P˙‚˙˙˙¤č„Ö‚ Hsgrad_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚#ƒÖ„[YEnter the month and year you graduated from high school or received your GED equivalency.…†˙˙‡˙žň„ŕ‚Highest_grade_completedƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚$ƒŕ…†˙˙‡˙dDr0‚ School2_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚tƒ0„97Enter the name of the second other school you attended.…†˙˙‡˙df‚ School2_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚uƒ„97Enter the city of the second other school you attended.…†˙˙‡˙„Š‚School2_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚vƒ„:8Enter the state of the second other school you attended.…†˙˙‡˙ŽL‚ School2_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚wƒ„=;Enter the zip code of the second other school you attended.…†˙˙‡˙F[ .l‚Explanation1_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Rƒl…†˙˙‡˙FŐ .ć ‚Explanation2_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚yƒć …†˙˙‡˙FZ' ‚Explanation1_addressƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Sƒ …†˙˙‡˙BŒ!V'ˆ"‚Explanation2_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚zƒˆ"…†˙˙‡˙0)‹! .|"‚Explanation2_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚|ƒ|"…†˙˙‡˙0)!.‚Explanation1_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Uƒ…†˙˙‡˙ôHx)V‚Citizenship_countryƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚xƒV…†˙˙‡˙c*Ş".´'‚„˙  ‚˙‚ €€€˙˙˙˙˙˙§".§"‚„˙  ‚˙˙p*ĺ '.ŕ‚„˙  ‚˙‚ €€€˙˙˙˙˙˙b*°".€$‚Federal_retirement„˙ ‚ b*I,. #€$Bb* #I,r$‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚%ƒr$„­ŤClick "Yes" if you receive, or have ever applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service.…†˙˙‡˙˙I, #.r$‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚&ƒr$„ľłClick "No" if you do NOT receive, and have NEVER applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service.…†˙˙‡˙˙b* #b*€$‚„˙  ‚˙˙˙I, #I,€$‚„˙  ‚˙˙˙. #.€$‚„˙  ‚˙˙˙b* #. #‚„˙  ‚˙˙˙b*€$.€$‚„˙  ‚˙˙˙˙Cb*°"b* #‚„˙  ‚˙˙˙I,°"I, #‚„˙  ‚˙˙˙.°". #‚„˙  ‚˙˙˙b*°".°"‚„˙  ‚˙˙˙b*°"I, #‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙I,°". #‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙#.a‚„˙ Œ˙Mailing Address‚˙˙˙Ŕs. ‚„˙ (‚˙‚ ˙˙˙˙˙˙ŻŽ(.Ä‚„˙ ‚˙‚ ˙˙˙Č¸Ď-Ć‚„˙ ˙˙˙Č˙}z BACKGROUND INFORMATION - PśYou must answer each question in this section before we can process your application.P˙‚˙˙˙8Ń9%W‚„˙ Œ˙ţűAre you a citizen of the United States? ( In most cases you must be a U.S. citizen to be hired. You will be required to submit proof of identity and citizenship at the time you are hired. ) If "NO", give the country or countries you are a citizen of:‚˙˙˙p*¸(.j‚ Us_citizen„˙ ‚ p*W,(.šjBp*šW,j‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚'ƒj„&$Click "Yes" if you are a US Citizen.…†˙˙‡˙˙W,š(.j‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚(ƒj„›™Click "No" if you are not a US citizen. If you are not a citizen, in the adjacent blank, fill out the country (or countries) of which you are a citizen.…†˙˙‡˙˙p*šp*j‚„˙  ‚˙˙˙W,šW,j‚„˙  ‚˙˙˙(.š(.j‚„˙  ‚˙˙˙p*š(.š‚„˙  ‚˙˙˙p*j(.j‚„˙  ‚˙˙˙˙Cp*¸p*š‚„˙  ‚˙˙˙W,¸W,š‚„˙  ‚˙˙˙(.¸(.š‚„˙  ‚˙˙˙p*¸(.¸‚„˙  ‚˙˙˙p*¸W,š‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙W,¸(.š‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙ăć-9 ‚„˙ Œ˙BNOTE: It is important that you give complete and truthful answers to questions 38 through 44. B If you answer B"YES"B to any of them, provide your explanation(s) in BItem 45. IncludeB convictions resulting from a plea of nolo contendere ( no contest ). BOmit:B 1) traffic fines of $ 100.00 or less; 2) any violation of law committed before your 16th birthday; 3) any violation of law committed before your 18th birthday, if finally decided in juvenile court or under a Youth Offender law; 4) any conviction set aside under the Federal Youth Corrections Act or similar State law; 5) any conviction whose record was expunged under Federal or State law. We will consider the date, facts and circumstances of each event you list. In most cases you can still be considered for Federal jobs. However,B if you fail to tell the truth or fail to list all relevant Bevents or circumstances, this may be grounds for not hiring you, for firing you after you begin work, or for criminal prosecution (18 USC 1001).‚˙˙˙o* '.Ô ‚ Quit_fired„˙ ‚ o*V,'.ţ Ô Bo*ţ V,Đ ‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚)ƒĐ „šˇClick "Yes" if, in the last 10 years, you were fired from any job for any reason, quit after being told you were fired, or left a job by mutual agreement because of specific problems.…†˙˙‡˙˙V,ţ '.Đ ‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚*ƒĐ „ÍËClick "No" if, in the last 10 years, you were NOT fired from any job for any reason, did NOT quit after being told you were fired, or did NOT leave a job by mutual agreement because of specific problems.…†˙˙‡˙˙o*ţ o*Ô ‚„˙  ‚˙˙˙V,ţ V,Ô ‚„˙  ‚˙˙˙'.ţ '.Ô ‚„˙  ‚˙˙˙o*ţ '.ţ ‚„˙  ‚˙˙˙o*Ô '.Ô ‚„˙  ‚˙˙˙˙Co* o*ţ ‚„˙  ‚˙˙˙V, V,ţ ‚„˙  ‚˙˙˙'. '.ţ ‚„˙  ‚˙˙˙o* '. ‚„˙  ‚˙˙˙o* V,ţ ‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙V, '.ţ ‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙b; *Á ‚„˙ Œ˙ĂŔDuring the last 10 years, were you fired from any job for any reason, did you quit after being told that you would be fired, or did you leave by mutual agreement because of specific problems?‚˙˙˙_Ď ‡*Ď ‚„˙  ‚˙˙b c%E‚„˙ Œ˙:7Have you ever been convicted of, or forfeited collateral for any felony violation? ( Generally, a felony is defined as any violation of law punishable by imprisonment of longer than one year, except for violations called misdemeanors under State law which are punishable by imprisonment of two years or less. )‚˙˙˙o*p'.h‚Background_39to41„˙ ‚o*V,'.plthBo*pV,B‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚+ƒB„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*lV,>‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚,ƒ>„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*tV,F‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚-ƒF„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙V,p'.B‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚.ƒB„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,l'.>‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚/ƒ>„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,t'.F‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚0ƒF„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙o*po*h‚„˙  ‚˙˙˙V,pV,h‚„˙  ‚˙˙˙'.p'.h‚„˙  ‚˙˙˙o*p'.p‚„˙  ‚˙˙˙o*l'.l‚„˙  ‚˙˙˙o*t'.t‚„˙  ‚˙˙˙o*h'.h‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_o‡*o‚„˙  ‚˙˙_•`%g‚„˙ Œ˙74Are you now under charges for any violation of law?‚˙˙˙_m‡*m‚„˙  ‚˙˙o*('.$‚Background_42to43„˙ ‚ o*V,'.("$Bo*(V,ú‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚1ƒú„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*"V,ô‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚2ƒô„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙V,('.ú‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚3ƒú„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,"'.ô‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚4ƒô„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙o*(o*$‚„˙  ‚˙˙˙V,(V,$‚„˙  ‚˙˙˙'.('.$‚„˙  ‚˙˙˙o*('.(‚„˙  ‚˙˙˙o*"'."‚„˙  ‚˙˙˙o*$'.$‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_‘`%‚„˙ Œ˙ŇĎDuring the Blast 10 yearsB have you forfeited collateral, been convicted, been imprisoned, been on probation, or been on parole? Do Bnot Binclude violations reported in 39, 40, or 41, above.‚˙˙˙_'‡*'‚„˙  ‚˙˙_C`%‚„˙ Œ˙urHave you BeverB been convicted by a military Bcourt-martial?B If no military service, answer "NO"‚˙˙˙_#‡*#‚„˙  ‚˙˙p*č(.ä‚Background_44„˙ ‚ p*W,(.čäBp*čW,ş‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚5ƒş„íëClick "Yes" if you are deliquent on any federal debt, including taxes, loans, overpayment of benefits, and other debts to the U.S. Governmenet, PLUS defaults on Federally guaraneteed or insured loans such as student and mortgage loans.…†˙˙‡˙˙W,č(.ş‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚6ƒş„îěClick "No" if you are NOT deliquent on any federal debt, including taxes, loans, overpayment of benefits, and other debts to the U.S. Governmenet, OR defaults on Federally guaraneteed or insured loans such as student and mortgage loans.…†˙˙‡˙˙p*čp*ä‚„˙  ‚˙˙˙W,čW,ä‚„˙  ‚˙˙˙(.č(.ä‚„˙  ‚˙˙˙p*č(.č‚„˙  ‚˙˙˙p*ä(.ä‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_M%Ó‚„˙ Œ˙Are you delinquent on any Federal debt? ( Include delinquencies arising from Federal taxes, loans, overpayment of benefits, and other debts to the U.S. Government BplusB defaults on Federally guaranteed or insured loans such as student and home mortgage loans.)‚˙˙˙_ă‡*ă‚„˙  ‚˙˙_™`%k‚„˙ Œ˙zwHave you BeverB been convicted of, or forfeited collateral for anyB firearms or explosives violation?B‚˙˙˙_q‡*q‚„˙  ‚˙˙3+˝‚„˙ Œ˙?<B38 - BExplain for each job the problem(s) and your reason(s) for leaving. Give the employer's name and address. B39 through 43 -B Explain each violation. Give place of occurrence and name/address of police or court involved. B44 -B Explain the type, length and amount of the delinquency or default. and steps you are taking to correct errors or repay the debt. Give any identification number associated with the debt and the address of the Federal agency involved. If you need more space, use a sheet of paper, and include the item number.‚˙˙˙_§"‚Explanation_38to44„˙ ‚_sť­Ő(N z!§"B_­sŐ‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚7ƒŐ…†˙˙‡˙˙_Ős‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚8ƒ…†˙˙‡˙˙_s(‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚9ƒ(…†˙˙‡˙˙_(sN ‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚:ƒN …†˙˙‡˙˙_N sz!‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚;ƒz!…†˙˙‡˙˙_z!s§"‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚<ƒ§"…†˙˙‡˙˙s­ťŐ‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚=ƒŐ„*(Give the month and year of the incident.…†˙˙‡˙˙sŐť‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚>ƒ„*(Give the month and year of the incident.…†˙˙‡˙˙sť(‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚?ƒ(„*(Give the month and year of the incident.…†˙˙‡˙˙s(ťN ‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚@ƒN „*(Give the month and year of the incident.…†˙˙‡˙˙sN ťz!‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Aƒz!„*(Give the month and year of the incident.…†˙˙‡˙˙sz!ť§"‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Bƒ§"„*(Give the month and year of the incident.…†˙˙‡˙˙ť­Ő‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚CƒŐ„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťŐ‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Dƒ„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ť(‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Eƒ(„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ť(N ‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚FƒN „öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťN z!‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Gƒz!„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťz!§"‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Hƒ§"„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙_­_§"‚„˙ ‚˙˙˙s­s§"‚„˙ ‚˙˙˙ť­ť§"‚„˙ ‚˙˙˙­§"‚„˙ ‚˙˙˙_­­‚„˙ ‚˙˙˙_ŐŐ‚„˙ ‚˙˙˙_‚„˙ ‚˙˙˙_((‚„˙ ‚˙˙˙_N N ‚„˙ ‚˙˙˙_z!z!‚„˙ ‚˙˙˙_§"§"‚„˙ ‚˙˙˙˙C__­‚„˙ ‚˙˙˙ss­‚„˙ ‚˙˙˙ťť­‚„˙ ‚˙˙˙­‚„˙ ‚˙˙˙_‚„˙ ‚˙˙˙_s­‚„˙ Œ˙  Item No.‚˙˙˙‚ ˙˙˙˙˙˙˙sť­‚„˙ Œ˙Date (Mo./Yr.)‚˙˙˙‚ ˙˙˙˙˙˙˙ť­‚„˙ Œ˙ Explanation‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Item_numberƒDateƒ Explanation˙˙˙!.‚„˙  ‚˙˙$Ž!.Ž‚„˙  ‚˙˙+ľó+•‚„˙ Œ˙63Name of Employer, Police, Court, or Federal Agency‚˙˙˙'.'‚„˙  ‚˙˙+u.u‚„˙  ‚˙˙+ui G‚„˙ Œ˙City‚˙˙˙w'uľ)G‚„˙ Œ˙ State‚˙˙˙N)tŒ+F‚„˙ Œ˙Zip‚˙˙˙+'ó+ ‚„˙ Œ˙63Name of Employer, Police, Court, or Federal Agency‚˙˙˙ç .ç ‚„˙  ‚˙˙+ç i š!‚„˙ Œ˙City‚˙˙˙w'ç ľ)š!‚„˙ Œ˙ State‚˙˙˙@)ć ~+¸!‚„˙ Œ˙Zip‚˙˙˙bÓ"ƒ$Y$‚„˙ Œ˙§¤Do you receive, or have you ever applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service?‚˙˙˙_u$‡*u$‚„˙  ‚˙˙_Ą$€$'‚„˙ Œ˙ćăDo any of your relatives work for the United States Government or the United States Armed Forces? Include: father; mother; husband; wife; son; daughter; brother; sister; uncle; aunt; first cousin; nephew; niece; father-in-law; mother-in-law; son-in-law; daughter-in-law; brother-in-law; sister-in-law; stepfather; stepmother; stepson; stepdaughter; stepbrother; stepsister; half brother; and half sister If "YES", provide details below. If you need more space, use a sheet of paper.‚˙˙˙_Ą'‡*Ą'‚„˙  ‚˙˙_Ś'!.–-‚Listing_of_relatives„˙ ‚_Îę!.“(:*ĺ+–-B_“(Î:*‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Iƒ:*…†˙˙‡˙˙_:*Îĺ+‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Jƒĺ+…†˙˙‡˙˙_ĺ+Ζ-‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Kƒ–-…†˙˙‡˙˙Î“(ę:*‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Lƒ:*„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙Î:*ęĺ+‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Mƒĺ+„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙Îĺ+ę–-‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Nƒ–-„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙ę“(!.:*‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Oƒ:*„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙ę:*!.ĺ+‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Pƒĺ+„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙ęĺ+!.–-‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Qƒ–-„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙_“(_–-‚„˙ ‚˙˙˙Î“(Ζ-‚„˙ ‚˙˙˙ę“(ę–-‚„˙ ‚˙˙˙!.“(!.–-‚„˙ ‚˙˙˙_“(!.“(‚„˙ ‚˙˙˙_:*!.:*‚„˙ ‚˙˙˙_ĺ+!.ĺ+‚„˙ ‚˙˙˙_–-!.–-‚„˙ ‚˙˙˙˙C_Ś'_“(‚„˙ ‚˙˙˙ÎŚ'Γ(‚„˙ ‚˙˙˙ęŚ'ę“(‚„˙ ‚˙˙˙!.Ś'!.“(‚„˙ ‚˙˙˙_Ś'!.Ś'‚„˙ ‚˙˙˙_Ś'Ζ(‚„˙ Œ˙P˘NameP˙‚˙˙˙‚ ˙˙˙˙˙˙˙ÎŚ'ę“(‚„˙  ˙ Relationship‚˙˙˙‚ ˙˙˙˙˙˙˙ęŚ'!.“(‚„˙  ˙0-Department, Agency or Branch of Armed Forces‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒNameƒ Relationshipƒ Department˙˙˙Ăœ-!.Ą.‚„˙ ‚˙‚ ˙˙˙ÉŚ-y´.‚„˙ ˙˙˙Č˙96 SIGNATURE, CERTIFICATION, AND RELEASE OF INFORMATION‚˙˙˙E/ń(q0‚„˙ Ü˙ROYOU MUST SIGN THIS APPLICATION. Read the following carefully before you sign.‚˙˙˙_Ă0§)6‚„˙ Œ˙ŕÝA false statement on any part of your application may be grounds for not hiring you, or for firing you after you begin work. Also, you may be punished by fine or imprisonment (U.S. Code, title 18, section 1001). If you are a male born after December 31, 1959 you must be registered with the Selective Service System or have a valid exemption in order to be eligible for Federal employment. You will be required to certify as to your status at the time of appointment. I understand that any information I give may be investigated as allowed by law or Presidential order. I consent to the release of information about my ability and fitness for Federal employment by employers, schools, law enforcement agencies and other individuals and organizations, to investigators, personnel staffing specialists, and other authorized employees of the Federal Government. I certify that, to the best of my knowledge and belief, all of my statements are true, correct, complete, and made in good faith.‚˙˙˙_7.7‚„˙ (‚˙˙_)7çű7‚„˙ Œ˙30Signature ( Sign each application in dark ink )‚˙˙˙-!)7ĺ+ű7‚„˙ Œ˙.+BDATE SIGNED ( Month, day, year )B‚˙˙˙`q:!.q:‚„˙ (‚˙˙É0;ľ˜<‚„˙ Œ˙PPage 4P˙‚˙˙˙ˆ'ô( ‚Explanation1_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Tƒ …†˙˙‡˙Ľœ8ł×9‚Applicant_signatureƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Zƒ×9…†˙˙‡˙Ő!œ8Í*×9‚Signature_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mmmm d, yyyyƒ˙˙‚[ƒ×9…†˙˙‡˙b*á%.˘'‚ Gov_relative„˙  ‚ b*I,.Ë&˘'Bb*Ë&I,'‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚\ƒ'„¤˘Click "Yes" if you have any relatives who work for the United States Government or the United States Armed Forces. 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'‚„˙ Œ˙ P47P˙‚˙˙˙Ü7.ˆ9‚„˙ Œ˙ P48P˙‚˙˙˙r Ü‚„˙ Œ˙BIf "YES" in:B‚˙˙˙râ ´‚„˙ Œ˙ NOTE:‚˙˙˙Š'Œ!ö(ˆ"‚Explanation2_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚{ƒˆ"…†˙˙‡˙˙B˙˙˙˙˙˙CAAf˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙ý˙˙˙ý˙˙˙ý˙˙˙wxyz{|}~€‚ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ Ą˘Ł¤ĽŚ§¨ŠŞŤŹ­ŽŻ°ą˛ł´ľśˇ¸šşťź˝žżŔÁÂĂÄĹĆÇČÉĘËĚÍÎĎĐŃŇÓÔŐÖ×ŘŮÚŰÜÝŢßŕáâä˙˙˙˙č˙˙˙˙˙˙˙˙˙˙˙˙éęţ˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙Š FORMATA-01 ‹z(#Times New Roman#Arial"#Courier New1#Modern2˙˙Jžžââ‚ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚˙˙ƒâ…†˙˙‡˙žžââ‚Text_field_small„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˙˙ƒâ…†˙˙‡˙žžââ‚Checkbox_table„˙ ‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙  ‚˙˙˙€€â‚„˙  ‚˙˙˙âââ‚„˙  ‚˙˙˙â‚„˙  ‚˙˙˙€â€‚„˙  ‚˙˙˙âââ‚„˙  ‚˙˙˙˙Cž‚„˙  ‚˙˙˙€ž€‚„˙  ‚˙˙˙âžâ‚„˙  ‚˙˙˙žâž‚„˙  ‚˙˙˙ž€‚„˙ Č˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Č˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙  ‚˙˙˙ž€€‚„˙  ‚˙˙˙žââ‚„˙  ‚˙˙˙žžâ‚„˙  ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙žžââ‚ Point_10„˙ ‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙ ‚˙˙˙€€â‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙â‚„˙ ‚˙˙˙€â€‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙˙Cž‚„˙ ‚˙˙˙€ž€‚„˙ ‚˙˙˙âžâ‚„˙ ‚˙˙˙žâž‚„˙ ‚˙˙˙ž€‚„˙ Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙žžââ‚ Small_label„˙ é‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙ ‚˙˙˙€€â‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙â‚„˙ ‚˙˙˙€â€‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙˙Cž‚„˙ ‚˙˙˙€ž€‚„˙ ‚˙˙˙âžâ‚„˙ ‚˙˙˙žâž‚„˙ ‚˙˙˙ž€‚„˙ ‚ý˙˙˙„ý˙˙˙…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ Ą˘Ł¤ĽŚ§¨ŠŞŤŹ­ŽŻ°ą˛ł´ľśˇ¸šşťź˝žżŔÁÂĂÄĹĆÇČÉĘËĚÍÎĎĐŃŇÓÔŐÖ×ŘŮÚŰÜÝŢßŕáâăäĺćçčéęëěíîďđńňóôőö÷řůúűüýţ˙Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙žžââ‚ Table_9point„˙ Ŕč‚ €â€âB€€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€â‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒâ…†˙˙‡˙˙€â€‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒ€…†˙˙‡˙˙€€ââ‚„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚˙˙ƒâ…†˙˙‡˙˙â‚„˙ ‚˙˙˙€€â‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙â‚„˙ ‚˙˙˙€â€‚„˙ ‚˙˙˙âââ‚„˙ ‚˙˙˙˙Cž‚„˙ ‚˙˙˙€ž€‚„˙ ‚˙˙˙âžâ‚„˙ ‚˙˙˙žâž‚„˙ ‚˙˙˙ž€‚„˙ Œ˙A‚˙˙˙‚ ˙˙˙˙˙€žâ‚„˙ Œ˙B‚˙˙˙‚ ˙˙˙˙˙˙Rž‚„˙ ‚˙˙˙ž€€‚„˙ ‚˙˙˙žââ‚„˙ ‚˙˙˙žžâ‚„˙ ‚˙˙˙ž€‚„˙ đ˙1‚˙˙˙‚ ˙˙˙˙˙ž€â‚„˙ đ˙2‚˙˙˙‚ ˙˙˙˙˙˙NƒColAƒColB˙˙˙˙)ř đ-"‚„˙ ‚˙‚ ˙˙˙Ŕœ‚„˙ h˙Standard Form 171‚˙˙˙0Čć,č‚„˙ Ě˙0-BApplication for Federal EmploymentB‚˙˙˙řđ-"‚„˙ ˙˙˙Č˙RORead The Following Instructions Carefully Before You Complete This Application‚˙˙˙đ˛@„‚„˙ Œ˙74DO NOT SUBMIT A RESUME INSTEAD OF THIS APPLICATION.‚˙˙˙đ÷Ô‚„˙ Œ˙&#TYPE OR PRINT CLEARLY IN DARK INK.‚˙˙˙đ@¨. ‚„˙ Œ˙'$BIF YOU NEED MORE SPACE for an answer, use a sheet of paper the same size as this page.B On each sheet write your name, Social Security Number, the announcement number or job title, and the item number. Attach all additional forms and sheets to this application at the top of page 3.‚˙˙˙đŘ ¨^ ‚„˙ Œ˙Ž‹If you do not answer BallB questions fully and correctly, you may delay the review of your application and lose job opportunities.‚˙˙˙đ¨J‚„˙ Œ˙ŠBUnless you are asked for additional material in the announcement or qualification information, do not attachB any materials, such as: official position descriptions, performance evaluations, letters of recommendation, certificates of training, publications, etc. Any materials you attach which were not asked for may be removed from your application and will not be returned to you.‚˙˙˙đş¨¨‚„˙ Œ˙41BWe suggest that you keep a copyB of this application for your use. If you plan to make copies of your application, we suggest you leave itemsB 1, 48 and 49 Bblank. Complete these blank items each items each time you apply.B YOU MUST SIGN AND DATE, IN INK, EACH COPY YOU SUBMIT.B‚˙˙˙đލ‚„˙ Œ˙ŠŚBTo apply for a specific Federal civil service examinationB (whether or not a written test is required) orB a specific vacancy in an Federal agency:B‚˙˙˙2xšJ‚„˙ Œ˙74Read the announcement and other materials provided.‚˙˙˙2ČšN‚„˙ Œ˙heMake sure that your work experience and/or education meet the qualification requirements described.‚˙˙˙2Şšä‚„˙ Œ˙ÇÄMake sure the announcement is open for the job and location you are interested in. Announcements may be closed to receipt of applications for some types of jobs, grades, or geographic locations.‚˙˙˙2šX ‚„˙ Œ˙¸ľMake sure that you are allowed to apply. Some jobs are limited to veterans, or to people who work for the Federal Government or have worked for the Federal Government in the past.‚˙˙˙2Ś šÔ$‚„˙ Œ˙yvFollow any directions on "How to Apply". If a written test is required, bring any material you are instructed to bring to the test session. For example, you may be instructed to "Bring a completed SF 171 to the test." If a written test is not required, mail this application and all other forms required by the announcement to the address specified in the announcement.‚˙˙˙C%_Ł&‚„˙ ˙Work Experience (Item 24)‚˙˙˙đ¨&ŕ–)‚„˙ Œ˙  Carefully complete each experience block you need to describe your work experience. Unless you qualify based on education alone,B your rating will depend on your description of previous jobs. Do not leave out any jobs you held during the last ten years.B‚˙˙˙đđ)ŕŢ,‚„˙ Œ˙JGUnderB Description of WorkB, write a BclearB and Bbrief,B but BcompleteB description of your major duties and responsibilities for each job. Include any supervisory duties, special assignments, and your accomplishments in the job. We may verify your description with your former employers.‚˙˙˙đP-ŕÖ.‚„˙ Œ˙‘ŽIf you had a major change of duties or responsibilities while you worked for the same employer, describe each major change as a separate job.‚˙˙˙ě´/ä-Ě0‚„˙ ‚˙‚ ˙˙˙ěŔ/ä-Î0‚„˙ ˙˙˙Č˙,)Privacy Act and Public Burden Statements‚˙˙˙A1uă4‚„˙ x˙~The Office of Personnel Management is authorized to rate applicants for Federal jobs under sections 1302, 3301, and 3304 of title 5 of the U.S. Code. Section 1104 of title 5 allows the Office of Personnel Management to authorize other Federal agencies to rate applicants for Federal jobs. We need the information you put on this form and associated application forms to see how well your education and work skills qualify you for a Federal job. We also need information on matters such as citizenship and military service to see whether you are affected by laws we must follow in deciding who may be employed by the Federal Government.‚˙˙˙85uÚ8‚„˙ x˙{xWe must have your Social Security Number (SSN) to keep your records straight because other people may have the same name and birth date. The SSN has been used to keep records since 1943, when Executive Order 9397 asked agencies to do so. The Office of Personnel Management may also use your SSN to make requests for information about you from employers, schools, banks, and others who know you, but only as allowed by law or Presidential directive. The information we collect by using your SSN will be used for employment purposes and also may be used for studies, statistics, and computer matching to benefit and payment files.‚˙˙˙/9uă9‚„˙ x˙fcInformation we have about you may also be given to Federal, State, and local agencies for checking‚˙˙˙m+¨‚„˙ ˙*'Veteran Preference in Hiring (Item 22)‚˙˙˙@ć+Ž‚„˙ Œ˙—”BDO NOT LEAVE Item 22 BLANKB. If you do not claim veteran preference, place an B"X"B in the box next toB "NO PREFERENCE"B.‚˙˙˙@ôć+. ‚„˙ Œ˙ŢŰYou BcannotB receive veteran preference if you are retired or plan to retire at or above the rank of major or lieutenant commander, BunlessB you are disabled or retired from the active military Reserve.‚˙˙˙@Ě ć+ş‚„˙ Œ˙ńîTo receive veteran preference your separation from active duty must have been under honorable conditions. This includes honorable and general discharges. A clemencydischarge does not meet the requirements of the Veteran Preference Act.‚˙˙˙@ ć+‚„˙ Œ˙œ™BActive duty for training in the military Reserve and National Guard programs is not considered active duty for purposes of veteran preference.B‚˙˙˙@rć+‚„˙ Œ˙VSBTo qualify for preference you must meet ONEB of the following conditions:‚˙˙˙Şř+ä‚„˙ Œ˙ĘÇServed on active duty anytime between December 7, 1941, and July 1, 1955; (If you were a Reservist called to active duty between February 1, 1955 and July 1, 1955, you must meet condition 2, below.)‚˙˙˙ž¤Ü+v‚„˙ Œ˙or‚˙˙˙Tř+Ž‚„˙ Œ˙ÓĐServed on active duty any part of which was between July 2, 1955 and October 14, 1976 or a Reservist called to active duty between February 1, 1955 and October 14, 1976 and who served for more than 180 days;‚˙˙˙žnÜ+@‚„˙ Œ˙or‚˙˙˙ř+ ‚„˙ Œ˙ńîEntered on active duty between October 15, 1976 and September 7, 1980 or a Reservist who entered on active duty between October 15, 1976 and October 13, 1982 and received a Campaign Badge or Expeditionary Medal or are a disabled veteran;‚˙˙˙˘Î+l‚„˙ Œ˙or‚˙˙˙Mř+Ó‚„˙ Œ˙Š‡Enlisted in the Armed Forces after September 7, 1980 or entered active duty other than by enlistment on or after October 14, 1982 and:‚˙˙˙TüŔ+ę‚„˙ Œ˙completed 24 months of continuous active duty or the full period called or ordered to active duty, or were discharged under 10 U.S.C. 1171 or for hardship under 10 U.S.C. 1173 BandB received or were entitled to receive a Campaign Badge or Expeditionary Medal;B orB‚˙˙˙bčz+Č ‚„˙ Œ˙are a disabled veteran.‚˙˙˙@Ś%ě+”(‚„˙ Œ˙If you think you qualify for 10-Point Preference, review the requirements described in the Standard Form (SF) 15, Application for 10-Point Veteran Preference. The SF is available from any Federal Job Information Center. The 10-point preference groups are:‚˙˙˙)¸-ţ+‚„˙ Œ˙Ŕ˝Non-Compensably Disabled or Purple Heart Recipient. Compensably Disabled (less than 30%). Compensably Disabled (30% or more). Spouse, Widow(er) or Mother of a deceased or disabled veteran.‚˙˙˙@—!ě+…$‚„˙ Œ˙If you meet one of the four conditions above, you qualify for 5-point preference. If you want to claim 5-point preference BandB do not meet the requirements for 10-point preference, discussed below, place and B"X"B in the box next to B"5-POINT PREFERENCE".B‚˙˙˙@d,ě+R/‚„˙ Œ˙˙üIf you claim 10-point preference, place an B"X"B in the box next to the group that applies to you. To receive B10-point preference you must attach a completed SF 15 to this application together with the proof requested in the SF 15.B‚˙˙˙`>1¸-´3‚„˙ x˙b_on law violations or for other lawful purposes. We may send your name and address to State and local Government agencies, Congressional and other public offices, and public international organizations, if they request names of people to consider for employment. We may also notify your school placement office if you are selected for a Federal job.‚˙˙˙`ö3¸-Ö5‚„˙ x˙Giving us your SSN or any of the other information is voluntary. However, we cannot process your application, which is the first step toward getting a job, if you do not give us the information we request. Incomplete addresses and ZIP Codes will also slow processing.‚˙˙˙`6¸-H:‚„˙ x˙żźPublic burden reporting for this collection of information is estimated to vary from 20 to 360 minutes with an average of 50 minutes per response, including time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden to Reports and Forms Management Officer, U.S. Office of Personnel Management, 1900 E Street, N.W., Room 6410, Washington, D.C. 20415; and to the Office of Management and Budget, Paperwork Reduction Project (3206-0012), Washington, D.C. 20503.‚˙˙˙ěN;äR<‚„˙ đ˙PĘDETACH THIS PAGEP˙‚˙˙˙Hý€5‚„˙ ‚˙‚ ˙˙˙HQ€‰‚„˙ ‚˙‚ ˙˙˙H‘€É‚„˙ ‚˙‚ ˙˙˙H) €a ‚„˙ ‚˙‚ ˙˙˙HY€‘‚„˙ ‚˙‚ ˙˙˙H €D‚„˙ ‚˙‚ ˙˙˙HÝ€‚„˙ ‚˙‚ ˙˙˙`Y˜‘‚„˙ ‚˙‚ ˙˙˙`C ˜{ ‚„˙ ‚˙‚ ˙˙˙` ˜U ‚„˙ ‚˙‚ ˙˙˙`[˜“‚„˙ ‚˙‚ ˙˙˙`ż˜÷‚„˙ ‚˙‚ ˙˙˙`î!˜&"‚„˙ ‚˙‚ ˙˙˙`ń%˜)&‚„˙ ‚˙‚ ˙˙˙`ł,˜ë,‚„˙ ‚˙‚ ˙˙˙°H‚„˙ Œ˙4.‚˙˙˙°Łu‚„˙ Œ˙1.‚˙˙˙°K‚„˙ Œ˙2.‚˙˙˙°ë‚„˙ Œ˙3.‚˙˙˙HĄ&(s'‚„˙ Œ˙1.‚˙˙˙Hé)(ť*‚„˙ Œ˙2.‚˙˙˙HO-(!.‚„˙ Œ˙3.‚˙˙˙ŹŒÔ‚„˙ Œ˙a.‚˙˙˙ŹčŒş ‚„˙ Œ˙b.‚˙˙˙Fv1‚Applicant_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Rƒ1„#!Enter the city of your residence.…†˙˙‡˙U˙ç‚Highest_goverment_positionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚`ƒ…†˙˙‡˙r[.L ‚„˙ ‚˙‚ €€€˙˙˙rL/.K ‚„˙ ˙˙˙Č˙2/MILITARY SERVICE AND VETERAN PREFERENCE(Cont.)‚˙˙˙hŽ&)8‚„˙  ‚˙‚ €€€˙˙˙˙˙˙ö#K¤*+ ‚„˙ Œ˙Veteran Preference‚Ń˙X$hÇ-+‚Form_approvedƒText_field_small„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒ+„:8Enter the person who approved this application (if any).…†˙˙‡˙I$ڏ-i‚Form_reviewedƒText_field_small„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒi„1/Enter the person who reviewed this application.…†˙˙‡˙rŁIu‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙žLÖ ‚„˙ h˙/,Application for Federal Employment - SF 171‚˙˙˙žÁFË‚„˙  ˙b_Read the instructions before you complete this application. Type or print clearly in dark ink.‚˙˙˙žšžg‚„˙ ‚˙‚ ˙˙˙,„ÔG‚„˙ Œ˙]ZWhat kind of job are you applying for? IGive title and announcement no. (if any)I‚˙˙˙,ŰDŰ‚„˙  ‚˙˙*íň Ą‚„˙ Œ˙Social Security Number‚˙˙˙& íĄ‚„˙ Œ˙Sex‚˙˙˙,Ő DŐ ‚„˙  ‚˙˙$î < Ŕ ‚„˙ Œ˙ Birth date (Month, Day Year)‚˙˙˙şą D• ‚„˙ €€€‚˙‚ €€€˙˙˙˙˙˙$Ÿ < q ‚„˙ Œ˙Name (Last, First, Middle)‚˙˙˙,yDy‚„˙  ‚˙˙(ƒŚU‚„˙ Œ˙63Mailing Address (include apartment number, if any)‚˙˙˙,}D}‚„˙  ‚˙˙(}ÄO‚„˙ Œ˙City‚˙˙˙8}^O‚„˙ Œ˙ State‚˙˙˙$}ŔO‚„˙ Œ˙ Zip Code‚˙˙˙˛9Z‚„˙ €€€‚˙‚ €€€˙˙˙˙˙˙(5„‚„˙ Œ˙=:Other names ever used (e.g., maiden name, nickname, etc.)‚˙˙˙,YDY‚„˙  ‚˙˙(YČ +‚„˙ Œ˙ Home Phone‚˙˙˙,ÁDÁ‚„˙  ‚˙˙p Yf5‚„˙ Œ˙ Work Phone‚˙˙˙ýkĎ‚„˙ Œ˙ Area Code‚˙˙˙Z ý´Ď‚„˙ Œ˙ Area Code‚˙˙˙Á‚„˙  ‚˙˙rrÁ‚„˙  ‚˙˙lýĆ Ď‚„˙ Œ˙ Number‚˙˙˙ŕý:Ď‚„˙ Œ˙ Number‚˙˙˙šóôĹ‚„˙ Œ˙Ext.‚˙˙˙(ÇM‚„˙ Œ˙¸ľWere you ever employed as a civilian by the Federal Government? If B"NO"B go to BItem 11. BIf B"YES"B, mark each type of job you held with an B"X"B.‚˙˙˙(ůË‚„˙ Œ˙DAWhat is your highest grade, classification series and job title?‚˙˙˙(Łn u‚„˙ Œ˙Dates at highest grade:‚˙˙˙B Łh u‚„˙ Œ˙FROM‚˙˙˙ŢŁu‚„˙ Œ˙TO‚˙˙˙˛uu‚„˙ (‚˙˙źg.C ‚„˙ ‚˙‚ ˙˙˙ń[ i ‚„˙ ˙˙˙Č˙ AVAILABILITY‚˙˙˙I B Ď!‚„˙ Œ˙-*When can you start work? (Month and Year)‚˙˙˙h I ÖĎ!‚„˙ Œ˙jgWhat is the BlowestB pay you will accept? (You will not be considered for jobs which pay less)‚˙˙˙Eo##o#‚„˙  ‚˙˙h ł"Ž …#‚„˙ Œ˙ Pay $‚˙˙˙ł"ś…#‚„˙ Œ˙per‚˙˙˙`ł"ş…#‚„˙ Œ˙BORB Grade‚˙˙˙(Ą#hs$‚„˙ Œ˙74In what geographic area(s) are you willing to work?‚˙˙˙Dł&ł&‚„˙  ‚˙˙(ż&h‘'‚„˙ Œ˙Are you willing to work:‚˙˙˙f´&ă,‚Willing_to_work_hours„˙ ‚fJř'ş(—)m*?+,ă,Bfř'Jş(‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒş(„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙fş(JŒ)‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒŒ)„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f—)Ji*‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒi*„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙fm*J?+‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ?+„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f?+J,‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙f,Jă,‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒă,„=;Check if you are willing work the hours listed on the left.…†˙˙‡˙˙Jř'ş(‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒş(„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙Jş(Œ)‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒŒ)„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J—)i*‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒi*„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙Jm*?+‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒ?+„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J?+,‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ ƒ,„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙J,ă,‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒă,„DBClick if you are not willing to work the hours listed on the left.…†˙˙‡˙˙fř'fă,‚„˙  ‚˙˙˙Jř'Jă,‚„˙  ‚˙˙˙ř'ă,‚„˙  ‚˙˙˙fř'ř'‚„˙  ‚˙˙˙fş(ş(‚„˙  ‚˙˙˙f—)—)‚„˙  ‚˙˙˙fm*m*‚„˙  ‚˙˙˙f?+?+‚„˙  ‚˙˙˙f,,‚„˙  ‚˙˙˙fă,ă,‚„˙  ‚˙˙˙˙Cf´&fř'‚„˙  ‚˙˙˙J´&Jř'‚„˙  ‚˙˙˙´&ř'‚„˙  ‚˙˙˙f´&´&‚„˙  ‚˙˙˙f´&Jř'‚„˙ Č˙Yes‚ ˙‚ ˙˙˙˙˙˙˙J´&ř'‚„˙ Č˙No‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙d(°Ů(‚„˙ Œ˙%"A. 40 hours per week (full-time)?‚˙˙˙dť(fť(‚„˙  ‚˙˙dŮ(°Ť)‚„˙ Œ˙(%B. 25-32 hours per week (part-time)?‚˙˙˙d—)f—)‚„˙  ‚˙˙dľ)°‡*‚„˙ Œ˙(%C. 17-24 hours per week (part-time)?‚˙˙˙dm*fm*‚„˙  ‚˙˙dŒ*°^+‚„˙ Œ˙.+D. 16 or fewer hours per week (part-time)?‚˙˙˙dF+fF+‚„˙  ‚˙˙d^+°0,‚„˙ Œ˙.+E. An intermittent job (on-call/seasonal)?‚˙˙˙d,f,‚„˙  ‚˙˙d0,°-‚„˙ Œ˙,)F. Weekends, shifts, or rotating shifts?‚˙˙˙Eä,mä,‚„˙  ‚˙˙eĐ-,0‚Willing_to_work_months„˙ ‚eIĐ-—.Z/,0BeĐ-I—.‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ—.„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙e—.IZ/‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒZ/„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙eZ/I,0‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,0„GECheck if you are willing to work the time periods listed on the left.…†˙˙‡˙˙IĐ-—.‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ—.„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙I—.Z/‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒZ/„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙IZ/,0‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ,0„KICheck if you are not willing to work the time periods listed on the left.…†˙˙‡˙˙eĐ-e,0‚„˙  ‚˙˙˙IĐ-I,0‚„˙  ‚˙˙˙Đ-,0‚„˙  ‚˙˙˙eĐ-Đ-‚„˙  ‚˙˙˙e—.—.‚„˙  ‚˙˙˙eZ/Z/‚„˙  ‚˙˙˙e,0,0‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙ç,Vš-‚„˙ Œ˙Are you willing to work:‚˙˙˙h—.j—.‚„˙  ‚˙˙Rž.žp/‚„˙ Œ˙B. 1 to 4 months ?‚˙˙˙hZ/jZ/‚„˙  ‚˙˙Rx/žJ0‚„˙ Œ˙C. Less than 1 months ?‚˙˙˙C,0k,0‚„˙  ‚˙˙fń03‚Willing_to_travel_days„˙ ‚fJń0Ę1œ23Bfń0JĂ1‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒĂ1„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙fĘ1Jœ2‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒœ2„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙fœ2Jn3‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒn3„QOCheck if you are willing to travel away from home the times listed on the left.…†˙˙‡˙˙Jń0Ă1‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒĂ1„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙JĘ1œ2‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒœ2„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙Jœ2n3‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒn3„B@Check if are not willing to travel the times listed on the left.…†˙˙‡˙˙fń0f3‚„˙  ‚˙˙˙Jń0J3‚„˙  ‚˙˙˙ń03‚„˙  ‚˙˙˙fń0ń0‚„˙  ‚˙˙˙fĘ1Ę1‚„˙  ‚˙˙˙fœ2œ2‚„˙  ‚˙˙˙f33‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ No_checked˙˙˙;0U 1‚„˙ Œ˙1.Are you willing to travel away from home for:‚˙˙˙Q1á1‚„˙ Œ˙ A. 1 to 5 nights each month?‚˙˙˙gČ1iČ1‚„˙  ‚˙˙Qß1ą2‚„˙ Œ˙!B. 6 to 10 nights each month?‚˙˙˙g›2i›2‚„˙  ‚˙˙Q´2†3‚„˙ Œ˙$!C. 11 or more nights each month?‚˙˙˙A¤3i¤3‚„˙  ‚˙˙Óƒ3^4‚„˙ ‚˙‚ ˙˙˙ńy3[x4‚„˙ ˙˙˙Č˙+(MILITARY SERVICE AND VETERAN PREFERENCE‚˙˙˙î‡ ü)ü#‚„˙ Œ˙A>Were you discharged from the military service under honorable conditions? PyI(If your discharge was changed to "honorable" or "general" by a Discharge Review Board, answer "YES". If you received a clemency discharge, answered "NO".) If "NO", provide below the date and type of discharge you received.P˙I‚˙˙˙C*F .ü#‚Honorable_discharge„˙ ‚ C*0, .é"ü#BC*é"0,ť#‚Yes_honorable_discharge„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒť#„:8Click if you were discharged under honorable conditions.…†˙˙‡˙˙0,é" .ť#‚No_honorable_discharge„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒť#„ZXClick if you were not discharged under honorable conditions (enter date and type below).…†˙˙‡˙˙C*é"C*ü#‚„˙  ‚˙˙˙0,é"0,ü#‚„˙  ‚˙˙˙ .é" .ü#‚„˙  ‚˙˙˙C*é" .é"‚„˙  ‚˙˙˙C*ü# .ü#‚„˙  ‚˙˙˙˙CC*F C*é"‚„˙  ‚˙˙˙0,F 0,é"‚„˙  ‚˙˙˙ .F .é"‚„˙  ‚˙˙˙C*F .F ‚„˙  ‚˙˙˙C*F 0,é"‚„˙ Č˙YES‚Ĺ˙‚ ˙˙˙˙˙˙˙0,F .é"‚„˙ Č˙NO‚Ĺ˙‚ ˙˙˙˙˙˙˙˙NƒYes_honorable_dischargeƒNo_honorable_discharge˙˙˙ý÷#S*÷#‚„˙  ‚˙˙jf708‚Retire_maj_or_lt_com„˙ ‚ jJf708Bjf7J08‚ Checked_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ08„][Click if you have or you will retire at or above the rank of major or lieutenant commander.…†˙˙‡˙˙Jf708‚ Checked_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ƒ08„ecClick if you have not or you will not retire at or above the rank of major or lieutenant commander.…†˙˙‡˙˙jf7j08‚„˙  ‚˙˙˙Jf7J08‚„˙  ‚˙˙˙f708‚„˙  ‚˙˙˙jf7f7‚„˙  ‚˙˙˙j0808‚„˙  ‚˙˙˙˙Nƒ Checked_yesƒ Checked_no˙˙˙3˝6™%8‚„˙ Œ˙‹ˆDid you or will you retire at or above the rank of major or lieutenant commander? . . . . . . . . . . . . . . . . . . . . . . . . . . .‚˙˙˙@.8h.8‚„˙  ‚˙˙;38"38‚„˙  ‚˙˙Ao8.ő9‚„˙ Œ˙b_THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER PREVIOUS EDITION USABLE UNTIL 12-31-90‚˙˙˙˛";žŠ<‚„˙ Œ˙PPage 1P˙‚˙˙˙™.f‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙]%.R‚„˙ Č˙DO NOT WRITE IN THIS AREA‚˙˙˙:‰ .—‚„˙ Č˙.+IFOR USE OF EXAMINING OFFICE ONLYI‚˙˙˙­.z‚„˙ ŔŔŔ‚˙‚ €€€˙˙˙˙˙˙—.—‚„˙  ‚˙˙@.@‚„˙  ‚˙˙p°8 ‚‚„˙ Œ˙Date entered register‚˙˙˙˙ŚÇ&x‚„˙ Œ˙Form reviewed:‚˙˙˙ xČ&J‚„˙ Œ˙Form approved:‚˙˙˙ÔœÔ@‚„˙  ‚˙˙­Aý#Ě‚Preference_rating„˙ ‚­ ý#0 = ;ěĚB­0 = ‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚ƒ= …†˙˙‡˙˙­= ;‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚ ƒ;…†˙˙‡˙˙­;‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚!ƒ…†˙˙‡˙˙­ě‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚"ƒě…†˙˙‡˙˙­ěĚ‚ Option„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚#ƒĚ…†˙˙‡˙˙0  = ‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚$ƒ= …†˙˙‡˙˙=  ;‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚%ƒ;…†˙˙‡˙˙; ‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚&ƒ…†˙˙‡˙˙ ě‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚'ƒě…†˙˙‡˙˙ě Ě‚Grade„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚(ƒĚ…†˙˙‡˙˙ 0 ý#= ‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚)ƒ= …†˙˙‡˙˙ = ý#;‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚*ƒ;…†˙˙‡˙˙ ;ý#‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚+ƒ…†˙˙‡˙˙ ý#ě‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚,ƒě…†˙˙‡˙˙ ěý#Ě‚Earned_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚-ƒĚ…†˙˙‡˙˙­0 ­Ě‚„˙ ‚˙˙˙0 Ě‚„˙ ‚˙˙˙ 0  Ě‚„˙ ‚˙˙˙ý#0 ý#Ě‚„˙ ‚˙˙˙­0 ý#0 ‚„˙ ‚˙˙˙­= ý#= ‚„˙ ‚˙˙˙­;ý#;‚„˙ ‚˙˙˙­ý#‚„˙ ‚˙˙˙­ěý#ě‚„˙ ‚˙˙˙­Ěý#Ě‚„˙ ‚˙˙˙˙C­A­0 ‚„˙ ‚˙˙˙A0 ‚„˙ ‚˙˙˙ A 0 ‚„˙ ‚˙˙˙ý#Aý#0 ‚„˙ ‚˙˙˙­Aý#A‚„˙ ‚˙˙˙­AÇ ‚„˙ Œ˙  Option‚˙˙˙‚ ˙˙˙˙˙˙˙A Ç ‚„˙ Œ˙  Grade‚˙˙˙‚ ˙˙˙˙˙˙˙ Aý#0 ‚„˙ Œ˙Earned Rating‚˙˙˙‚ ˙˙˙˙˙˙˙˙Nƒ OptionƒGradeƒEarned_rating˙˙˙˛e%.e‚„˙  ‚˙˙“ß[ Ď‚„˙ Œ˙P˘Initials and DateP˙‚˙˙˙’*A .Ě‚Augmented_rating„˙ ‚’* ./ < :ëĚB’*/ .< ‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚.ƒ< „97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*< .:‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚/ƒ:„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*: .‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚0ƒ„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’* .ë‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚1ƒë„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*ë .Ě‚Augmented_rating„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚2ƒĚ„97Enter the augmented rating this applicant has received.…†˙˙‡˙˙’*/ ’*Ě‚„˙  ‚˙˙˙ ./ .Ě‚„˙  ‚˙˙˙’*/ ./ ‚„˙  ‚˙˙˙’*< .< ‚„˙  ‚˙˙˙’*: .:‚„˙  ‚˙˙˙’* .‚„˙  ‚˙˙˙’*ë .ë‚„˙  ‚˙˙˙’*Ě .Ě‚„˙  ‚˙˙˙˙C’*A’*/ ‚„˙  ‚˙˙˙ .A ./ ‚„˙  ‚˙˙˙’*A .A‚„˙  ‚˙˙˙’*A .Ç ‚„˙ Œ˙Augmented Rating‚Ń˙‚ ˙˙˙˙˙˙˙˙NƒAugmented_rating_entries˙˙˙ $, œ*, ‚„˙  ‚˙˙~% ˜)? ‚„˙ Œ˙No Preference Claimed‚˙˙˙~%C ˜)‚„˙ Œ˙5 Points (Tentative)‚˙˙˙~%(=*č‚„˙ Œ˙%"10 Pts. (30% or More Comp. Dis.)‚˙˙˙~%÷y*}‚„˙ Œ˙&#10 Pts. (Less Than 30% Comp. Dis.)‚˙˙˙%ވ*™‚„˙ Œ˙Other 10 Points‚Ń˙%׈*Ć‚„˙ Œ˙ Disallowed‚Ń˙°%äŤ*Ó‚„˙ Œ˙Being Investigated‚Ń˙:j.ŕ‚„˙ Č˙żźIFOR USE OF APPOINTING OFFICE ONLY BIPŽPreference has been verified through proof that the separation was under honorable conditions, and other proof as required.BP˙‚˙˙˙˜ëÁř‚„˙ Œ˙ 5 Points‚Ń˙Ěě$T‚„˙ Œ˙.+10-Pt.- 30% or More Compensable Disability‚˙˙˙Ô$ě +Ź‚„˙ Œ˙0-10-Pt.- Less Than 30% Compensable Disability‚˙˙˙š+ě/.ť‚„˙ Œ˙10-Point- Other‚˙˙˙Ď„— t‚„˙ Œ˙!P˘Signature and TitleP˙‚˙˙˙˛x%.x‚„˙  ‚˙˙Ď‘— c‚„˙ Œ˙ Agency‚˙˙˙6&‘ţ,c‚„˙ Œ˙Date‚˙˙˙&&ˇ‚„˙  ‚˙˙î÷#.@&‚Non_honorable_discharge„˙ ‚ îů#.f%@&Bîf%ů#@&‚Discharge_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚>ƒ@&„YWIf your discharge was not under honorable conditions, enter the date of your discharge.…†˙˙‡˙˙ů#f%.@&‚Discharge_type„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚?ƒ@&„a_If your discharge was not under honorable conditions, enter the type of discharge you received.…†˙˙‡˙˙îf%î@&‚„˙ ‚˙˙˙ů#f%ů#@&‚„˙ ‚˙˙˙.f%.@&‚„˙ ‚˙˙˙îf%.f%‚„˙ ‚˙˙˙î@&.@&‚„˙ ‚˙˙˙˙Cî÷#îf%‚„˙ ‚˙˙˙ů#÷#ů#f%‚„˙ ‚˙˙˙.÷#.f%‚„˙ ‚˙˙˙î÷#.÷#‚„˙ ‚˙˙˙î÷#ů#f%‚„˙ Œ˙'$Discharge Date ( Month, Day, Year )‚˙˙˙‚ ˙˙˙˙˙˙˙ů#÷#.f%‚„˙ Œ˙Type of Discharge‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒDischarge_dateƒDischarge_type˙˙˙îw&ˇ-I'‚„˙ Œ˙OLList the dates (Month, Day, Year ), and branch for all active duty military‚˙˙˙ó?'ó--*‚Active_duty_dates„˙  ‚ó$ó-R(B)-*BóR(ÂB)‚From_active_dates„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚@ƒB)„<:Enter the begining dates for your active military service.…†˙˙‡˙˙óB)Â-*‚From_active_dates„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚Aƒ-*„<:Enter the begining dates for your active military service.…†˙˙‡˙˙ÂR($B)‚Ending_active_duty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚BƒB)„:8Enter the ending dates for your active military service.…†˙˙‡˙˙ÂB)$-*‚Ending_active_duty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙ ‚ mm/dd/yyyyƒ˙˙‚Cƒ-*„:8Enter the ending dates for your active military service.…†˙˙‡˙˙$R(ó-B)‚Branch_of_service„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚DƒB)„;9Enter the branch(es) of the military in which you served.…†˙˙‡˙˙$B)ó--*‚Branch_of_service„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚Eƒ-*„;9Enter the branch(es) of the military in which you served.…†˙˙‡˙˙óR(ó-*‚„˙  ‚˙˙˙ÂR(Â-*‚„˙ ‚˙˙˙$R($-*‚„˙ ‚˙˙˙ó-R(ó--*‚„˙  ‚˙˙˙óR(ó-R(‚„˙ ‚˙˙˙óB)ó-B)‚„˙  ‚˙˙˙ó-*ó--*‚„˙  ‚˙˙˙˙Có?'óR(‚„˙  ‚˙˙˙Â?'ÂR(‚„˙ ‚˙˙˙$?'$R(‚„˙ ‚˙˙˙ó-?'ó-R(‚„˙  ‚˙˙˙ó?'ó-?'‚„˙  ‚˙˙˙ó?'ÂR(‚„˙ Œ˙From‚˙˙‚ ˙˙˙˙˙˙˙Â?'$R(‚„˙ Œ˙To‚˙˙‚ ˙˙˙˙˙˙˙$?'ó-R(‚„˙ Œ˙Branch of Service‚˙˙‚ ˙˙˙˙˙˙˙˙NƒFrom_active_datesƒEnding_active_dutyƒBranch_of_service˙˙˙óP*ř-š+‚„˙ Œ˙ÁžPyIf all your active military duty was after October 14, 1976, list the full names and dates of all campaign badges or expeditionary medals you received or were entitled to receive.P˙‚˙˙˙óß,î-ß,‚„˙  ‚˙˙óř,ř-#/‚„˙ Œ˙ńîBRead the instructions that came with this form before completing this item. BWhen you have determined your eligibility for veteran preference from the instructions, place an "X" in the box next to your veteran preference claim.‚˙˙˙Kx/—*J0‚„˙ Œ˙NO PREFERENCE‚˙˙˙QO0™-5‚„˙ Œ˙ť¸5-POINT PREFERENCE -- You must show proof when you are hired. 10-POINT PREFERENCE -- If you claim 10-point preference, place an "X" in the box below next to the basis for your claim. BTo receive 10-point preference you must also complete a Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center. ATTACH THE COMPLETED SF 15 AND REQUESTED PROOF TO THIS APPLICATION.B‚˙˙˙K^5—*06‚„˙ Œ˙74Non-Compensably disabled or Purple Heart recipient.‚˙˙˙K&6—*ř6‚„˙ Œ˙/,Compensably disabled, less than 30 percent.‚˙˙˙Kř6Ł-Ę7‚„˙ Œ˙C@Spouse, widow(er), or mother of a deceased or disabled veteran.‚˙˙˙KÔ7Ł-Ś8‚„˙ Œ˙-*Compensably disabled, 30 percent or more.‚˙˙˙óÝ8ó-Ý8‚„˙ ‚˙˙ 9î-D;‚„˙ Œ˙a^Standard Form B171B # (Rev. 6-88) U.S. Office of Personnel Management FPM Chapter 295‚˙˙˙ž.€‚„˙  ˙# Form Approved OMB No. 3206-0012‚˙˙˙ …2t‚„˙ Œ˙ Temporary‚Ń˙Ă…ůt‚„˙ Œ˙Career-Conditional‚Ń˙­…2e‚„˙ Œ˙ Career‚Ń˙Ÿ‰x‚„˙ Œ˙ Excepted‚Ń˙Ułk Đ ‚Applicant_ssnƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚OƒĐ „USEnter your Social Security Number (SSN). Press to advance to the next field.…†˙˙‡˙U k Ť ‚Applicant_birthdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyyyƒ˙˙‚PƒŤ „B@Enter your birthdate. Press to advance to the next field.…†˙˙‡˙FO Řl‚Applicant_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Qƒl„ljEnter your name. Use a comma to separate your last name, first name, and middile initial (if applicable).…†˙˙‡˙f71‚Applicant_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Sƒ1„MKUsing all capital letters, enter the two-letter abbreviation of your state.…†˙˙‡˙A1‚Applicant_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Tƒ1„Enter your zip code.…†˙˙‡˙U ç=‚Appliant_aliasƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Uƒ=„nlEnter any other names (aliases) that you have ever used. Common aliases include maiden names and nicknames.…†˙˙‡˙6‘莂Home_area_codeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚VƒŽ…†˙˙‡˙n ‘LŽ‚Work_area_codeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚WƒŽ…†˙˙‡˙q‘AŽ‚Work_extensionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚XƒŽ…†˙˙‡˙>‘V Ž‚Home_phone_numberƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚YƒŽ…†˙˙‡˙„‘5Ž‚Work_phone_numberƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ZƒŽ…†˙˙‡˙F>Řj‚Applicant_addressƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚[ƒj„A?Enter your mailing address. Include apartment numbers, if any.…†˙˙‡˙ irY‚ Temporary„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚\ƒY„ECClick if you were ever employed as a temporary government employee.…†˙˙‡˙lé\‚ Career„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚]ƒ\„PNClick if you were ever employed as a government employee in a career position.…†˙˙‡˙xlŕ\‚ Excepted„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚^ƒ\„SQClick if you were ever employed as a government employee in an excepted position.…†˙˙‡˙Śl \‚Career_conditional„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚_ƒ\„\ZClick if you were ever employed as a government employee in a career-conditional position.…†˙˙‡˙Ź ?\\‚Highest_grade_fromƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚aƒ\…†˙˙‡˙KNű\‚Highest_grade_toƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚bƒ\…†˙˙‡˙iD"C C#‚Available_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚cƒC#„OMEnter the date (the month and year) that you will be available to start work.…†˙˙‡˙A D"˜B#‚ Lowest_payƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚dƒB#…†˙˙‡˙ÄD"YR#‚Lowest_pay_timeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚eƒR#„žœEnter the time period for the pay amount listed. Use a two-letter abbreviation (e.g., "hr" for hour,"bi" for bi-monthly, "mo" for month, or "yr" for year).…†˙˙‡˙B"|R#‚ Lowest_gradeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚fƒR#…†˙˙‡˙UQ$çš&‚Geographic_areasƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚gƒš&…†˙˙‡˙j_4˘6‚Military_service„˙  ‚ jLÇ5˘6BjÇ5L™6‚ Yes_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚hƒ™6„—•Check if you have served in the United States Military Service. If your only active duty was training in the Reserves or National Guard answer "NO".…†˙˙‡˙˙LÇ5™6‚ No_checked„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚iƒ™6„ĆÄCheck if you have not served in the United States Military Service. If your only active duty was training in the Reserves or National Guard answer "NO". If you check "NO" go directly to item 22.…†˙˙‡˙˙jÇ5j˘6‚„˙  ‚˙˙˙LÇ5L˘6‚„˙  ‚˙˙˙Ç5˘6‚„˙  ‚˙˙˙jÇ5Ç5‚„˙  ‚˙˙˙j˘6˘6‚„˙  ‚˙˙˙˙Cj_4jÇ5‚„˙  ‚˙˙˙L_4LÇ5‚„˙  ‚˙˙˙_4Ç5‚„˙  ‚˙˙˙j_4_4‚„˙  ‚˙˙˙j_4LÇ5‚„˙ Č˙Yes‚˙‚ ˙˙˙˙˙˙˙L_4Ç5‚„˙ Č˙No‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Yes_checkedƒ No_checked˙˙˙3s4@­6‚„˙ Œ˙ť¸Have you served in the United States Military Service? If your only active duty was training in the Reserves or National Guard answer "NO". IfB "NO"B, go to item 22. . . . . .‚˙˙˙@ž6hž6‚„˙  ‚˙˙Ć_u1‚Date_entered_registerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyyyƒ˙˙‚jƒ1„@>Enter the date this application was entered into the register.…†˙˙‡˙:ý )‚Person_checkingƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚kƒ)„ Enter the reviewer's initials.…†˙˙‡˙6 ýp$)‚Initial_datesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚lƒ)„.,Enter the date that this form was initialed.…†˙˙‡˙ QÁ-n‚Signature_and_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚mƒn„B@Enter the signature and title of the preference verifying party.…†˙˙‡˙ mœ%{‚ Agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚nƒ{…†˙˙‡˙đ&m­-Š‚Date_of_preferenceƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚oƒŠ…†˙˙‡˙%•+ˇ-Đ,‚Badgesandmedalsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚pƒĐ,„ľłIf all your active military duty was after October 14, 1976, list the full names and dates of all campaign badges or expeditionary medals you received or were entitled to receive.…†˙˙‡˙QuŒ’‚„˙ Œ˙ Pň1P˙‚˙˙˙QÜŒ ‚„˙ Œ˙ Pň2P˙‚˙˙˙L ܇  ‚„˙ Œ˙ Pň3P˙‚˙˙˙L î ‡ ) ‚„˙ Œ˙ Pň5P˙‚˙˙˙ î KŔ ‚„˙ Œ˙+(Birthplace (City and State or Country)‚˙˙˙J ˘ ذ ‚Applicant_birthplaceƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚qƒ° „ŽŒEnter your the city and state of your birth, or country of your birth (if you were foreign-born). Press to advance to the next field.…†˙˙‡˙Qî Œ) ‚„˙ Œ˙ Pň4P˙‚˙˙˙Q› ŒÖ ‚„˙ Œ˙ Pň6P˙‚˙˙˙Q&Œa‚„˙ Œ˙ Pň7P˙‚˙˙˙Q`Œ›‚„˙ Œ˙ Pň8P˙‚˙˙˙f `Ą ›‚„˙ Œ˙ Pň9P˙‚˙˙˙ăU ­"‚„˙ Œ˙ Pň11P˙‚˙˙˙ăÖ‚„˙ Œ˙ Pň10P˙‚˙˙˙ U M ­"‚„˙ Œ˙ Pň12P˙‚˙˙˙ă“#ë%‚„˙ Œ˙ Pň13P˙‚˙˙˙ă¸&)‚„˙ Œ˙ Pň14P˙‚˙˙˙ăî,F/‚„˙ Œ˙ Pň15P˙‚˙˙˙ă60Ž2‚„˙ Œ˙ Pň16P˙‚˙˙˙ă´4 7‚„˙ Œ˙ Pň17P˙‚˙˙˙ăó6K9‚„˙ Œ˙ Pň18P˙‚˙˙˙•‡ Đß"‚„˙ đ˙19‚˙˙˙•Y&Đą(‚„˙ đ˙20‚˙˙˙•P*Đ|+‚„˙ đ˙21‚˙˙˙•ý,Đ .‚„˙ đ˙22‚˙˙˙ńˆ \‚„˙ ˙˙˙Č˙GENERAL INFORMATION‚˙˙˙RĚ-žž.‚„˙ Œ˙)&A. 5 to 12 months (Sometimes longer)?‚˙˙˙& "Ě‚ Job_typeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚}ƒĚ„ˇľEnter a general description of the kind of job you are applying for. If available, provide the title and announcement number for the job. Press to advance to the next field.…†˙˙‡˙ěˇqŚ ‚„˙  ˙Male‚Ń˙ŢťĚŞ ‚„˙  ˙ Female‚Ń˙!‚„˙)ŔžŽŽ ‚Applicant_gender_male„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Ü˙‚ƒ˙˙‚~ƒŽ „ecCheck the appropriate box. You cannot check both boxes. Press to advance to the next field.…†˙˙‡˙ˇžŽ ‚Applicant_gender_female„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙Č˙‚ƒ˙˙‚ƒŽ „ecCheck the appropriate box. You cannot check both boxes. Press to advance to the next field.…†˙˙‡˙˙˙!‚„˙)R$m ş%+ ‚No_preference_claimed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚3ƒ+ „64Click if the applicant did not claim any preference.…†˙˙‡˙R$1 ş%ď ‚Five_points_claimed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚4ƒď „-+Click if the applicant claimed five points.…†˙˙‡˙R$ş%Ň‚Ten_points_plus_30_percent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚5ƒŇ„_]Click if the applicant claimed ten preference points with 30% or more compensable disability.…†˙˙‡˙R$íş%Ť‚" Ten_points_less_than_30_percent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚6ƒŤ„a_Click if the applicant claimed ten preference points with less than 30% compensable disability.…†˙˙‡˙a$ŻÉ%m‚Other_ten_points„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚7ƒm„USClick if the applicant claimed an "other" 10 point preference for any other reason.…†˙˙‡˙a$ŃÉ%‚ Disallowed„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙‚ƒ˙˙‚8ƒ„53Click if the applicant's preference was disallowed.…†˙˙‡˙k$äÓ%˘‚Being_investigated„˙ ‚˙‚ ˙˙˙˙˙˙˙ý˙˙˙      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~€ €´˙‚ƒ˙˙‚9ƒ˘„HFClick if the applicant's preferences are currently being investigated.…†˙˙‡˙˙˙!‚„˙)™Ďż‚Five_point_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚:ƒż„NLClick here if five point preference has been verified by all required proof.…†˙˙‡˙×Ń?Á‚Ten_point_plus_30_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚;ƒÁ„wuClick here if ten point preference (with 30% or more compensable disability) has been verified by all required proof.…†˙˙‡˙Ő#Ń=%Á‚Ten_point_less_30_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚<ƒÁ„ywClick here if ten point preference (with less than 30% compensable disability) has been verified by all required proof.…†˙˙‡˙ľ*Ń,Á‚Ten_point_other_verified„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚=ƒÁ„XVClick here if an "other" ten point preference has been verified by all required proof.…†˙˙‡˙˙˙!‚„˙)âĆ5v¸6‚Disabled_compless30„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚†ƒ¸6…†˙˙‡˙âÖ4vČ5‚Disabled_noncomp„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚‡ƒČ5…†˙˙‡˙âŞ6vœ7‚ Spouse„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚Œƒœ7…†˙˙‡˙â˜7vŠ8‚Disabled_compmore30„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚ƒŠ8…†˙˙‡˙ŕú/tě0‚Preference_5point„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚„ƒě0…†˙˙‡˙ŕ /tü/‚Preference_none„˙ ‚˙‚ ˙˙˙˙˙˙˙ ˙˙‚ƒ˙˙‚…ƒü/…†˙˙‡˙˙˙œ#'8+‚Job2_employerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚^ƒ+…†˙˙‡˙œ 8n‚Job1_employerƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚tƒn„{yEnter your most recent employer's address. Press to begin a new line. Press to advance to the next field.…†˙˙‡˙bó%”‚„˙ Œ˙May we ask your present employer about your character, qualifications, and work record? A "NO" will not affect our review of your qualifications. If you answer "NO" and we need to contact your present employer before we can offer you a job, we will contact you first............‚˙˙˙b E* ‚„˙  ‚˙˙)*ö. ‚Contact_employer„˙  ‚ )* ,.ý B)*ý ,í‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚rƒí„64Click "Yes" if we may contact your current employer.…†˙˙‡˙˙ ,ý.í‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙‚ƒ˙˙‚sƒí„DBClick "No" if you do not want us to contact your current employer.…†˙˙‡˙˙)*ý)* ‚„˙  ‚˙˙˙ ,ý , ‚„˙  ‚˙˙˙.ý. ‚„˙  ‚˙˙˙)*ý.ý‚„˙  ‚˙˙˙)* . ‚„˙  ‚˙˙˙˙C)*ö)*ý‚„˙  ‚˙˙˙ ,ö ,ý‚„˙  ‚˙˙˙.ö.ý‚„˙  ‚˙˙˙)*ö.ö‚„˙  ‚˙˙˙)*ö ,ý‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙ ,ö.ý‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙q‚IS‚„˙ Œ˙HEREAD BWORK EXPERIENCEB IN THE INSTRUCTIONS BEFORE YOU BEGIN.‚˙˙˙4<9* ‚„˙ Œ˙1.Describe your current or most recent job in Block BAB and work backwards, describing each job you held Bduring the past 10 years.B If you were BunemployedB for longer than B3 monthsB within the past 10 years, list the dates and your address(es) in an experience block.‚˙˙˙4Œ 9Ć ‚„˙ Œ˙ŇĎYou may sum up in one block work that you did Bmore than 10 years ago.B But if that work Bis relatedB to the type of job you are applying for, describe each related job in a separate block.‚˙˙˙4j 9X‚„˙ Œ˙YVINCLUDE VOLUNTEER WORK ( non-paid work )-- BIf the workB ( or a part of the work )B is like the job you are applying for,B complete BallB parts of the experience block just as you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations.‚˙˙˙Ýyâ-g‚„˙ Œ˙ INCLUDE MILITARY SERVICE-- You should complete BallB parts of the experience block just as you would for a non-military job, including all supervisory experience. Describe each major change of duties or responsibilities in a separate experience block.‚˙˙˙ÜÁá-Ż ‚„˙ Œ˙IF YOU NEED MORE SPACE TO DESCRIBE A JOB-- Use sheets of paper the same size as this page (be sure to include all information we ask for in BAB and BB Bbelow). On BeachB sheet show your name, Social Security Number, and the announcement number or job title.‚˙˙˙ÜK á-Ń ‚„˙ Œ˙MJIF YOU NEED MORE EXPERIENCE BLOCKS, use the SF 171-A or a sheet of paper.‚˙˙˙Ý_â-ĺ‚„˙ Œ˙heIF YOU NEED TO UPDATE (ADD MORE RECENT JOBS), use the SF 172 or a sheet of paper as described above.‚˙˙˙q'.‚„˙ ‚˙˙7°Á‚„˙ Œ˙NKName and address of employer's organization ( include ZIP Code, if known )‚˙˙˙T+T‡‚„˙  ‚˙˙ry(.y‚„˙  ‚˙˙o+x!ď‚„˙ Œ˙74P˘P˙Dates employed (give month, day and year)‚˙˙˙č!+č!‡‚„˙  ‚˙˙ö!+(Á‚„˙ Œ˙$!Average number of hours per week‚˙˙˙˜'˜'…‚„˙  ‚˙˙´'+¸-ł‚„˙ Œ˙&#Number of employees you supervised‚˙˙˙bw(.w‚„˙ ‚˙˙~—Zi‚„˙ Œ˙ From:‚˙˙˙ä—Ŕi‚„˙ Œ˙To:‚˙˙˙o“x!e‚„˙ Œ˙Salary or earnings‚˙˙˙~s¸E‚„˙ Œ˙ Starting‚˙˙˙~}¸O‚„˙ Œ˙ Ending‚˙˙˙ sÚE‚„˙ Œ˙$‚˙˙˙ }ÚO‚„˙ Œ˙$‚˙˙˙Bs| E‚„˙ Œ˙per‚˙˙˙B}| O‚„˙ Œ˙per‚˙˙˙ö!“z+e‚„˙ Œ˙$!Your reason for wanting to leave‚˙˙˙rÓ(.Ó‚„˙  ‚˙˙•Ź g‚„˙ Œ˙Your immediate supervisor‚˙˙˙/~‚„˙ Œ˙Name‚˙˙˙Ž KŽ Ó‚„˙  ‚˙˙› /š‚„˙ Œ˙ Area Code‚˙˙˙t Kt Ó‚„˙  ‚˙˙ /œ‚„˙ Œ˙Telephone No.‚˙˙˙$y$á‚„˙  ‚˙˙1•^g‚„˙ Œ˙Exact title of your job‚˙˙˙:y:á‚„˙  ‚˙˙HÔ-ׂ„˙ Œ˙”‘PyIf Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotionP˙‚˙˙˙€íĆ-‚„˙  ˙PMDescription of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work ( for example, carpentry and painting, or personnel and budget ), write the approximate percentage of time you spent doing each.‚˙˙˙rŠ%(.Š%‚„˙ (‚˙˙˛+;ž“<‚„˙ Œ˙PPage 2P˙‚˙˙˙ [;.i<‚„˙ Č˙URIF YOU NEED MORE EXPERIENCE BLOCKS, USE SF 171 - A (SEE BACK OF INSTRUCTION PAGE)‚˙˙˙ţ.9T‚„˙ Œ˙ Pň23P˙‚˙˙˙ Žcě‚„˙ Œ˙ Pň24P˙‚˙˙˙!‚„˙)řQ‚„˙ ‚˙‚ ˙˙˙ Hy‚„˙ ˙˙˙Œ˙ PAP˙‚˙˙˙˙˙!‚„˙)ř%Ă&‚„˙ ‚˙‚ ˙˙˙ ƒ%Hë&‚„˙ ˙˙˙Œ˙ PBP˙‚˙˙˙˙˙0'ä`‚Job1_startdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚uƒ`„&$Enter the date you started this job.…†˙˙‡˙î'˘!`‚ Job1_enddateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚vƒ`„YWEnter the date which you left the job. If you are currently employed, enter "Present".…†˙˙‡˙X"‰ 'i‚ Job1_hoursƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚wƒi„0.Enter the number of hours per week you worked.…†˙˙‡˙x(‰,-i‚Job1_employeesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚xƒi„53Enter the total number of employees you supervised.…†˙˙‡˙HNü.‚Job1_startpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚yƒ.„:8Enter your salary at the time of starting this position.…†˙˙‡˙HEü%‚ Job1_endpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚zƒ%„97Enter your salary at the time of leaving this position.…†˙˙‡˙vE†!B‚ Job1_endperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚{ƒB„NLEnter the time period for the ending salary listed (hour, month, year, etc.)…†˙˙‡˙ "Hâ-\‚ Job1_reasonƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚|ƒ\…†˙˙‡˙€×€ ˇ‚ Job1_superƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚}ƒˇ…†˙˙‡˙Ş ×X ˇ‚Job1_areacodeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚~ƒˇ„@>Enter the area code of your immediate supervisor for this job.…†˙˙‡˙‚ ס‚ Job1_phoneƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒˇ„CAEnter the phone number of your immediate supervisor for this job.…†˙˙‡˙@С‚ Job1_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚€ƒˇ…†˙˙‡˙V× .ˇ‚ Job1_federalƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒˇ…†˙˙‡˙#•#.›%‚„˙ ‚˙‚ ˙˙˙~#ą#-ƒ$‚„˙ Œ˙:7rgbFor Agency Use (skill codes, etc.)d˙‚˙˙˙ÔeV-A#‚Job1_descriptionƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚‚ƒA#„ZXEnter a description of your work at this job. Press to advance to the next field.…†˙˙‡˙$u$.%‚ Job1_agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒƒ%„KIEnter any specific codes (for indexing, validating, etc.) for the agency.…†˙˙‡˙ľ%°?'‚„˙ Œ˙NKName and address of employer's organization ( include ZIP Code, if known )‚˙˙˙TŠ%T+‚„˙  ‚˙˙r+(.+‚„˙  ‚˙˙oˇ%x!{&‚„˙ Œ˙74P˘P˙Dates employed (give month, day and year)‚˙˙˙č!Š%č!+‚„˙  ‚˙˙ö!ˇ%(M'‚„˙ Œ˙$!Average number of hours per week‚˙˙˙˜'›%˜'(‚„˙  ‚˙˙´'ˇ%¸-R'‚„˙ Œ˙&#Number of employees you supervised‚˙˙˙b((.(‚„˙ ‚˙˙~'Zç'‚„˙ Œ˙ From:‚˙˙˙ä'Ŕç'‚„˙ Œ˙To:‚˙˙˙o(x!ă(‚„˙ Œ˙Salary or earnings‚˙˙˙~ń(¸Ă)‚„˙ Œ˙ Starting‚˙˙˙~ű)¸Í*‚„˙ Œ˙ Ending‚˙˙˙ ń(ÚĂ)‚„˙ Œ˙$‚˙˙˙ ű)ÚÍ*‚„˙ Œ˙$‚˙˙˙Bń(| Ă)‚„˙ Œ˙per‚˙˙˙Bű)| Í*‚„˙ Œ˙per‚˙˙˙ö!(z+ă(‚„˙ Œ˙$!Your reason for wanting to leave‚˙˙˙r_-(._-‚„˙  ‚˙˙+Ź ĺ+‚„˙ Œ˙Your immediate supervisor‚˙˙˙­+~,‚„˙ Œ˙Name‚˙˙˙Ž Ü+Ž d-‚„˙  ‚˙˙ ­+Œ,‚„˙ Œ˙ Area Code‚˙˙˙‚ Ü+‚ d-‚„˙  ‚˙˙ ­+œ,‚„˙ Œ˙Telephone No.‚˙˙˙$+$_-‚„˙  ‚˙˙1+^ĺ+‚„˙ Œ˙Exact title of your job‚˙˙˙: +:_-‚„˙  ‚˙˙H +Ô-U,‚„˙ Œ˙”‘PyIf Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job, the date of your last promotionP˙‚˙˙˙€k-Ć-˙/‚„˙  ˙PMDescription of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work ( for example, carpentry and painting, or personnel and budget ), write the approximate percentage of time you spent doing each.‚˙˙˙r'; .';‚„˙ (‚˙˙#9. ;‚„˙ ‚˙‚ ˙˙˙€#9-ĺ9‚„˙ Œ˙:7rgbFor Agency Use (skill codes, etc.)d˙‚˙˙˙vN†!.‚Job1_startperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚”ƒ.„PNEnter the time period for the starting salary listed (hour, month, year, etc.)…†˙˙‡˙0ô&äă'‚Job2_startdateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚_ƒă'„&$Enter the date you started this job.…†˙˙‡˙îä&˘!ă'‚ Job2_enddateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mm/dd/yyƒ˙˙‚`ƒă'„(&Enter the date which you left the job.…†˙˙‡˙X" ' 'ě'‚ Job2_hoursƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚aƒě'„0.Enter the number of hours per week you worked.…†˙˙‡˙x( ',-ě'‚Job2_employeesƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚bƒě'„53Enter the total number of employees you supervised.…†˙˙‡˙€d,€ D-‚ Job2_superƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚gƒD-…†˙˙‡˙ś d,d D-‚Job2_areacodeƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚hƒD-„@>Enter the area code of your immediate supervisor for this job.…†˙˙‡˙‚ d,D-‚ Job2_phoneƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚iƒD-„CAEnter the phone number of your immediate supervisor for this job.…†˙˙‡˙0\,D-‚ Job2_titleƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚jƒD-…†˙˙‡˙V6, .4-‚ Job2_federalƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚kƒ4-…†˙˙‡˙Ôč/V-Ä8‚Description_of_work_2ƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚lƒÄ8„ZXEnter a description of your work at this job. Press to advance to the next field.…†˙˙‡˙$ř9.;‚ Job2_agencyƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚mƒ;„KIEnter any specific codes (for indexing, validating, etc.) for the agency.…†˙˙‡˙Hß(üż)‚Job2_startpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚oƒż)„:8Enter your salary at the time of starting this position.…†˙˙‡˙HÖ)üś*‚ Job2_endpayƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙˙˙0.00˙˙˙˙˙-0.00˙„˙˙˙˙‚pƒś*„97Enter your salary at the time of leaving this position.…†˙˙‡˙vÖ)†!â*‚ Job2_endperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚qƒâ*„NLEnter the time period for the ending salary listed (hour, month, year, etc.)…†˙˙‡˙ "Ř(â-ě*‚ Job2_reasonƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚rƒě*…†˙˙‡˙vß(†!ż)‚Job2_startperƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚sƒż)„PNEnter the time period for the starting salary listed (hour, month, year, etc.)…†˙˙‡˙!‚„˙)¸â'.ç‚„˙ ‚˙‚ ˙˙˙Çěœ,Ü‚„˙ ˙˙˙Č˙c`WORK EXPERIENCE If you have no work experience, write "NONE" in A below and go to 25 on page 3.‚˙˙˙˙˙¨6ţ-.‚ High_schoolƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ.…†˙˙‡˙7ˆ,…¤.‚„˙ Œ˙îëDo you speak or read a language other than EnglishI (include sign language)I? BIApplicants for jobs that require a language other than English may be given an interview conducted solely in that language.BI‚˙˙˙˛ˇ!.ź‚„˙ ‚˙‚ ˙˙˙¸ł!ł‚„˙ ˙˙˙Č˙ EDUCATION‚˙˙˙<ŇŚ!¨‚„˙ Č˙*'ATTACH ANY ADDITIONAL FORMS AND SHEETS‚˙˙˙FFě F‚„˙ (‚˙”ě FFF˙č×n‚„˙ Œ˙–“Did you graduate from high school? If you have a GED high school equivalency or will graduate within the next nine months, answer B"YES".B‚˙˙˙[ @y#F‚Attend_college„˙ ‚ ÷!y#@AFB÷!@y#ĺ‚Attended_college„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚–ƒĺ„ЧClick "YES" if you have attended a college or graduate school, and go to item 28. Click "NO" if you have not attended a college or graduate school, and go to item 31.…†˙˙‡˙˙÷!Ay#ć‚Attended_college„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚—ƒć„ЧClick "YES" if you have attended a college or graduate school, and go to item 28. Click "NO" if you have not attended a college or graduate school, and go to item 31.…†˙˙‡˙˙÷!@÷!F‚„˙  ‚˙˙˙y#@y#F‚„˙  ‚˙˙˙÷!@y#@‚„˙  ‚˙˙˙÷!Ay#A‚„˙  ‚˙˙˙÷!Fy#F‚„˙  ‚˙˙˙˙R[ @÷!@‚„˙  ‚˙˙˙[ A÷!A‚„˙  ‚˙˙˙[ F÷!F‚„˙  ‚˙˙˙[ @[ F‚„˙  ‚˙˙˙[ @÷!A‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙[ A÷!F‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙NƒAttended_college˙˙˙‡śÝ!‚„˙ Œ˙ROIfB "YES",B give month and year graduated or received GED equivalency:‚™˙‡šä‚„˙ Œ˙<9IfB "NO",B give the highest grade you completed:‚™˙šč -`‚„˙ Œ˙ŒWrite the name and location ( city and state ) of the last high school you attended or where you obtained your GED high school equivalency.‚˙˙˙™@ .@‚„˙  ‚˙˙—zÝ‚„˙ Œ˙63Have you ever attended college or graduate school?‚˙˙˙ĐšČ‚ Hs_grad„˙ ‚ ĄšĐĚČBĄĐšu‚ Yes_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚˜ƒu„}If you graduated from high school, will graduate in the next nine months, or have a GED, click "YES". Otherwise, click "NO".…†˙˙‡˙˙ĄĚšq‚ Yes_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚™ƒq„}If you graduated from high school, will graduate in the next nine months, or have a GED, click "YES". Otherwise, click "NO".…†˙˙‡˙˙ĄĐĄČ‚„˙  ‚˙˙˙šĐšČ‚„˙  ‚˙˙˙ĄĐšĐ‚„˙  ‚˙˙˙ĄĚšĚ‚„˙  ‚˙˙˙ĄČšČ‚„˙  ‚˙˙˙˙RĐĄĐ‚„˙  ‚˙˙˙ĚĄĚ‚„˙  ‚˙˙˙ČĄČ‚„˙  ‚˙˙˙ĐČ‚„˙  ‚˙˙˙ĐĄĚ‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙ĚĄČ‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙Nƒ Yes_no˙˙˙K$jˇ,<‚„˙ Œ˙30IfB "YES",B continue withB 28.B‚™˙K$Xy**‚„˙ Œ˙*'IfB "NO", Bgo toB 31.B‚™˙óŽóD‚„˙ ‚˙˙F.F‚„˙ ‚˙˙˘ !.Ä‚Colleges_attended„˙ ‚ŰÇ…™łöK"Ď$S'í*!.˘ X ÄBŰ˘ ÇX ‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚šƒX „/-Enter the names of any colleges you attended.…†‡˙˙ŰX Ç‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚›ƒ„/-Enter the names of any colleges you attended.…†‡˙˙ŰÇÄ‚ College_name„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚œƒÄ„/-Enter the names of any colleges you attended.…†‡˙˙Ç˘ …X ‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒX „Enter the college's city.…†‡˙˙ÇX …‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚žƒ„Enter the college's city.…†‡˙˙Ç…Ä‚ College_city„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŸƒÄ„Enter the college's city.…†‡˙˙…˘ ™X ‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ ƒX „Enter the college's state.…†‡˙˙…X ™‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ąƒ„Enter the college's state.…†‡˙˙…™Ä‚College_state„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˘ƒÄ„Enter the college's state.…†‡˙˙™˘ łX ‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚كX „Enter the college's zip code.…†‡˙˙™X ł‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¤ƒ„Enter the college's zip code.…†‡˙˙™łÄ‚ College_zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ĽƒÄ„Enter the college's zip code.…†‡˙˙ł˘ öX ‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ڃX „31Enter the date you started attending the college.…† ‡˙˙łX ö‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚§ƒ„31Enter the date you started attending the college.…† ‡˙˙łöÄ‚College_startdate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¨ƒÄ„31Enter the date you started attending the college.…† ‡˙˙ö˘ K"X ‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ЃX „<:Enter the date on which you stopped attending the college.…† ‡˙˙öX K"‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ރ„<:Enter the date on which you stopped attending the college.…† ‡˙˙öK"Ä‚College_enddate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŤƒÄ„<:Enter the date on which you stopped attending the college.…† ‡˙˙K"˘ Ď$X ‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ʃX „:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙K"X Ď$‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚­ƒ„:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙K"Ď$Ä‚College_semesters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ރÄ„:8Enter the number of semester credit hours you completed.…†˙˙‡˙˙Ď$˘ S'X ‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚݃X „53Enter the number of quarter credit hours completed.…†˙˙‡˙˙Ď$X S'‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚°ƒ„53Enter the number of quarter credit hours completed.…†˙˙‡˙˙Ď$S'Ä‚College_quarters„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ąƒÄ„53Enter the number of quarter credit hours completed.…†˙˙‡˙˙S'˘ í*X ‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˛ƒX „><Enter the type of degree program in which you were enrolled.…†‡˙˙S'X í*‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚łƒ„><Enter the type of degree program in which you were enrolled.…†‡˙˙S'í*Ä‚College_degree„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚´ƒÄ„><Enter the type of degree program in which you were enrolled.…†‡˙˙í*˘ !.X ‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ľƒX „86Enter the month and year that you received the degree.…†‡˙˙í*X !.‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚śƒ„86Enter the month and year that you received the degree.…†‡˙˙í*!.Ä‚College_degreedate„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ˇƒÄ„86Enter the month and year that you received the degree.…†‡˙˙Ű˘ ŰÄ‚„˙  ‚˙˙˙Ç˘ ÇÄ‚„˙  ‚˙˙˙…˘ …Ä‚„˙  ‚˙˙˙™˘ ™Ä‚„˙  ‚˙˙˙ł˘ łÄ‚„˙  ‚˙˙˙ö˘ öÄ‚„˙  ‚˙˙˙K"˘ K"Ä‚„˙  ‚˙˙˙Ď$˘ Ď$Ä‚„˙  ‚˙˙˙S'˘ S'Ä‚„˙  ‚˙˙˙í*˘ í*Ä‚„˙  ‚˙˙˙!.˘ !.Ä‚„˙  ‚˙˙˙Ű˘ !.˘ ‚„˙  ‚˙˙˙ŰX !.X ‚„˙  ‚˙˙˙Ű!.‚„˙  ‚˙˙˙ŰÄ!.Ä‚„˙  ‚˙˙˙˙R˘ ۢ ‚„˙  ‚˙˙˙X ŰX ‚„˙  ‚˙˙˙Ű‚„˙  ‚˙˙˙ÄŰÄ‚„˙  ‚˙˙˙˘ Ä‚„˙  ‚˙˙˙˘ ŰX ‚„˙  ˙1)‚Œ˙‚ ˙˙˙˙˙˙˙X Ű‚„˙  ˙2)‚‹˙‚ ˙˙˙˙˙˙˙ŰÄ‚„˙  ˙3)‚‹˙‚ ˙˙˙˙˙˙˙˙Nƒ College_nameƒ College_cityƒCollege_stateƒ College_zipƒCollege_startdateƒCollege_enddateƒCollege_semestersƒCollege_quartersƒCollege_degreeƒCollege_degreedate˙˙˙doę ‚„˙ Œ˙ľ˛NAME AND LOCATION ( city, state and ZIP Code ) OF COLLEGE OR UNIVERSITY. If you expect to graduate within nine months, give the month and year you expect to receive your degree:‚˙˙˙ę i'ę ‚„˙  ‚˙˙ř [Ž ‚„˙ Œ˙Name‚˙˙˙[ô ×Ć ‚„˙ Œ˙City‚˙˙˙Šô wĆ ‚„˙ Œ˙ State‚˙˙˙wô ÉĆ ‚„˙ Œ˙  ZIP Code‚˙˙˙ťô ëŽ ‚„˙ Œ˙From‚˙˙˙í$ř G'Ź ‚„˙ x˙ Quarter‚˙˙˙Áę Áź ‚„˙  ‚˙˙ę Ę ‚„˙  ‚˙˙“ę “Ę ‚„˙  ‚˙˙­F­Ř ‚„˙  ‚˙˙ůę ůĘ ‚„˙  ‚˙˙S"FS"ź ‚„˙  ‚˙˙['F['ź ‚„˙  ‚˙˙×$ę ×$Ę ‚„˙  ‚˙˙st™"ú ‚„˙ x˙MONTH AND YEAR ATTENDED‚˙˙˙E"tk'ž ‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙'u+d ‚„˙ x˙/,TYPE OF DEGREE I(e.g. B.A., M.A.)I‚˙˙˙é*Fé*ź ‚„˙  ‚˙˙ç*t#.T ‚„˙ x˙MONTH AND YEAR OF DEGREE‚˙˙˙˘Č†‚Chief_undergrad_subj„˙ ‚ŃđäȢ˜†BŃ˘đ˜‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚¸ƒ˜„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Ń˜đ‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚šƒ„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Ńđ†‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚şƒ†„igEnter the names of your chief undergraduate school subject areas, listing your major on the first line.…†˙˙‡˙˙đ˘ä˜‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ťƒ˜„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙đ˜ä‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚źƒ„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙đä†‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚˝ƒ†„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙ä˘Č˜‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚žƒ˜„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙ä˜Č‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚żƒ„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙äČ†‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚Ŕƒ†„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙Ń˘Ń†‚„˙  ‚˙˙˙đ˘đ†‚„˙  ‚˙˙˙ä˘ä†‚„˙  ‚˙˙˙Č˘Č†‚„˙  ‚˙˙˙Ń˘Č˘‚„˙  ‚˙˙˙Ń˜Č˜‚„˙  ‚˙˙˙ŃČ‚„˙  ‚˙˙˙Ń†Č†‚„˙  ‚˙˙˙˙R˘Ń˘‚„˙  ‚˙˙˙˜Ń˜‚„˙  ‚˙˙˙Ń‚„˙  ‚˙˙˙†Ń†‚„˙  ‚˙˙˙˘†‚„˙  ‚˙˙˙˘Ń˜‚„˙  ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙˜Ń‚„˙  ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙Ń†‚„˙  ˙3)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ SubjectsƒSemester_hoursƒQuarter_hours˙˙˙ Óć‚„˙ x˙  Semester‚˙˙˙ňž˛‚„˙ x˙ Quarter‚˙˙˙ôÄôœ‚„˙  ‚˙˙ĹÄĹŚ‚„˙  ‚˙˙äţ䢂„˙  ‚˙˙=Ęc‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙öřÄř‚„˙  ‚˙˙ýţ„‚„˙ Œ˙GDCHIEF UNDERGRADUATE SUBJECTS IShow major on the first lineI‚˙˙˙x˘.†‚Chief_grad_subj„˙ ‚4Y(H+.˘˜†B4˘Y(˜‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Áƒ˜„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙4˜Y(‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ƒ„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙4Y(†‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Æ„dbEnter the names of your chief graduate school subject areas, listing your major on the first line.…†˙˙‡˙˙Y(˘H+˜‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ă˜„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙Y(˜H+‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚я„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙Y(H+†‚Semester_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ƃ†„B@Enter the number of semester credit hours taken in each subject.…†˙˙‡˙˙H+˘.˜‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ǃ˜„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙H+˜.‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ȃ„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙H+.†‚Quarter_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚Ƀ†„A?Enter the number of quarter credit hours taken in each subject.…†˙˙‡˙˙4˘4†‚„˙  ‚˙˙˙Y(˘Y(†‚„˙  ‚˙˙˙H+˘H+†‚„˙  ‚˙˙˙.˘.†‚„˙  ‚˙˙˙4˘.˘‚„˙  ‚˙˙˙4˜.˜‚„˙  ‚˙˙˙4.‚„˙  ‚˙˙˙4†.†‚„˙  ‚˙˙˙˙Rx˘4˘‚„˙  ‚˙˙˙x˜4˜‚„˙  ‚˙˙˙x4‚„˙  ‚˙˙˙x†4†‚„˙  ‚˙˙˙x˘x†‚„˙  ‚˙˙˙x˘4˜‚„˙  ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙x˜4‚„˙  ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙x4†‚„˙  ˙3)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ SubjectsƒSemester_hoursƒQuarter_hours˙˙˙_(A+ć‚„˙ x˙  Semester‚˙˙˙S+0.´‚„˙ x˙ Quarter‚˙˙˙X(ÄX(Ş‚„˙  ‚˙˙G+ţG+œ‚„˙  ‚˙˙›(ĘÁ-‚„˙ x˙$!NUMBER OF CREDIT HOURS COMPLETED‚˙˙˙\(ř!.ř‚„˙  ‚˙˙[ţe(„‚„˙ Œ˙B?CHIEF GRADUATE SUBJECTS IShow major on the first lineI‚˙˙˙'†!.†‚„˙  ‚˙˙'†0.ý‚„˙ Œ˙¸ľIf you have completed any Bother courses or training related to the kind of jobs you are applying for ( trade, vocational, Armed Forces, business ) give information below.B‚˙˙˙ä#.ä‚„˙  ‚˙˙'ş +ş‚„˙  ‚˙˙bq4‚„˙ Œ˙GDNAME AND LOCATION I( city, state, and ZIP Code ) IOF SCHOOL‚˙˙˙}  ę‚„˙ Œ˙From‚˙˙˙qňq΂„˙  ‚˙˙Î‚„˙  ‚˙˙ŁňŁŔ‚„˙  ‚˙˙}ÜŁ&‚„˙ x˙MONTH AND YEAR ATTENDED‚˙˙˙q Ł ‚„˙  ‚˙˙Mę_ę‚„˙ Œ˙Class Room Hours‚˙ďäďŔ‚„˙  ‚˙˙ýT‘+&‚„˙ Œ˙ Subject(s)‚˙˙˙+‘,ň‚„˙ Œ˙Yes‚˙˙˙+ě+Č‚„˙  ‚˙˙ , ,Č‚„˙  ‚˙˙#.ě#.ş‚„˙  ‚˙˙+ä.J‚„˙ x˙Training Completed‚˙˙˙ +.‚„˙  ‚˙˙qś!."‚Other_schools„˙ ‚q ¤î+Ą,!.śç$eÚ"Bqś ç‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ʃç„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qç $‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚˃$„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙q$ e‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚̃e„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qe ‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚̓„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙q Ú‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚΃Ú„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙qÚ "‚ Start_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚σ"„LJEnter the date (month and year) in which you started attending the school.…†˙˙‡˙˙ ś¤ç‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ѓç„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ ç¤$‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚у$„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ $¤e‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚҃e„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ e¤‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ӄ„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ ¤Ú‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ԃÚ„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙ Ú¤"‚ End_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚Ճ"„LJEnter the date (month and year) in which you stopped attending the school.…†˙˙‡˙˙¤śîç‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚փç„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤çî$‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚׃$„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤$îe‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚؃e„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤e Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ك„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤îÚ‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ڃÚ„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙¤Úî"‚ Class_hours„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ˙˙˙˙0.0˙˙˙˙˙-0.0˙„˙˙˙˙‚ۃ"„YWEnter the total amount of class hours you accumulated during your period of attendance.…†˙˙‡˙˙îś+ç‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚܃ç„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îç+$‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚݃$„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙î$+e‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ރe„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îe+‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚߃„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙î+Ú‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ŕƒÚ„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙îÚ+"‚ Subjects„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚áƒ"„><Enter your primary subject area studied while in attendance.…†˙˙‡˙˙+śĄ,ˆ‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚⃈„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+çĄ,š‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ăƒš„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+$Ą,ö‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚äƒö„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+eĄ,7‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ĺƒ7„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+Ą,o‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ćƒo„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙+ÚĄ,Ź‚Completed_yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚çƒŹ„JHClick "Yes" if you completed the training program in which you enrolled.…†˙˙‡˙˙Ą,ś!.ˆ‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚čƒˆ„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,ç!.š‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚郚„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,$!.ö‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ęƒö„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,e!.7‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ëƒ7„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,!.o‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚ěƒo„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙Ą,Ú!.Ź‚ Completed_no„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚íƒŹ„PNClick "No" if you did not complete the training program in which you enrolled.…†˙˙‡˙˙qśq"‚„˙  ‚˙˙˙ ś "‚„˙  ‚˙˙˙¤ś¤"‚„˙  ‚˙˙˙îśî"‚„˙  ‚˙˙˙+ś+"‚„˙  ‚˙˙˙Ą,śĄ,"‚„˙  ‚˙˙˙!.ś!."‚„˙  ‚˙˙˙qś!.ś‚„˙  ‚˙˙˙qç!.ç‚„˙  ‚˙˙˙q$!.$‚„˙  ‚˙˙˙qe!.e‚„˙  ‚˙˙˙q!.‚„˙  ‚˙˙˙qÚ!.Ú‚„˙  ‚˙˙˙q"!."‚„˙  ‚˙˙˙˙Nƒ Start_dateƒ End_dateƒ Class_hoursƒ SubjectsƒCompleted_yesƒ Completed_no˙˙˙€q€‚„˙  ‚˙˙Ŕ•v‚„˙ Œ˙1) School Name‚˙˙˙Ž•`‚„˙ Œ˙City‚˙˙˙ĹŽO`‚„˙ Œ˙ State‚˙˙˙ËŽG`‚„˙ Œ˙ Zip Code‚˙˙˙q€qj‚„˙  ‚˙˙jqj‚„˙  ‚˙˙Ą€Ąj‚„˙  ‚˙˙FqF‚„˙  ‚˙˙x•J‚„˙ Œ˙2) School Name‚˙˙˙T•&‚„˙ Œ˙City‚˙˙˙ĹTA&‚„˙ Œ˙ State‚˙˙˙ËTG&‚„˙ Œ˙ Zip Code‚˙˙˙qJq0‚„˙  ‚˙˙"q"‚„˙  ‚˙˙ĄLĄ"‚„˙  ‚˙˙´#. ‚„˙ ‚˙‚ ˙˙˙şż# ‚„˙ ˙˙˙Č˙.+SPECIAL SKILLS, ACCOMPLISHMENTS AND AWARDS‚˙˙˙ Ľ-X"‚„˙ Œ˙–“Give the title and year of any honors, awards or fellowships you have received. List your special qualifications, skills or accomplishments that may help you get a job. Some examples are: skills with computers or other machines; most important publications ( do not submit copies ); public speaking and writing experience; membership in professional or scientific societies; patents or inventions; etc.‚˙˙˙'§'1.§'‚„˙  ‚˙˙ś'm đ)‚„˙ Œ˙<9How many words per minute can you: TYPE? TAKE DICTATION?‚˙˙˙s ś'Ý-ˆ(‚„˙ Œ˙‡„List job-related licenses or certificates that you have, such as: registered nurse; lawyer; radio operator; driver's; pilot's; etc.‚˙˙˙!‚„˙)g %)!.ˆ,‚ Licenses„˙ ‚$ łß&!.›*‘+ˆ,B$ ›*ł‘+‚ License„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚+„/-Enter the name of the license or certificate.…†˙˙‡˙˙$ ‘+łˆ,‚ License„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ďƒˆ,„/-Enter the name of the license or certificate.…†˙˙‡˙˙ł›*ß&‘+‚ License_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ‚ dd/mm/yyyyƒ˙˙‚đƒ‘+„OMEnter the date of the awarding or last renewal of the license or certificate.…†˙˙‡˙˙ł‘+ß&ˆ,‚ License_date„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙ ‚ dd/mm/yyyyƒ˙˙‚ńƒˆ,„OMEnter the date of the awarding or last renewal of the license or certificate.…†˙˙‡˙˙ß&›*!.‘+‚License_agency„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚ňƒ‘+„PNEnter the state or licensing agency which awarded this license or certificate.…†˙˙‡˙˙ß&‘+!.ˆ,‚License_agency„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙˙‚óƒˆ,„PNEnter the state or licensing agency which awarded this license or certificate.…†˙˙‡˙˙$ ›*$ ˆ,‚„˙  ‚˙˙˙ł›*łˆ,‚„˙  ‚˙˙˙ß&›*ß&ˆ,‚„˙  ‚˙˙˙!.›*!.ˆ,‚„˙  ‚˙˙˙$ ›*!.›*‚„˙  ‚˙˙˙$ ‘+!.‘+‚„˙  ‚˙˙˙$ ˆ,!.ˆ,‚„˙  ‚˙˙˙˙C$ %)$ ›*‚„˙ ‚˙˙˙ł%)ł›*‚„˙  ‚˙˙˙ß&%)ß&›*‚„˙  ‚˙˙˙!.%)!.›*‚„˙ ‚˙˙˙$ %)!.%)‚„˙  ‚˙˙˙$ %)ł›*‚„˙ Œ˙LICENSE OR CERTIFICATE‚˙‚ ˙˙˙˙˙˙˙ł%)ß&›*‚„˙ Œ˙*'DATE OF LATEST LICENSE OR CERTIFICATE‚˙˙˙‚ ˙˙˙˙˙˙˙ß&%)!.›*‚„˙ Œ˙$!STATE OR OTHER LICENSING AGENCY‚˙˙˙‚ ˙˙˙˙˙˙˙˙Rg ›*$ ›*‚„˙  ‚˙˙˙g ‘+$ ‘+‚„˙  ‚˙˙˙g ˆ,$ ˆ,‚„˙  ‚˙˙˙g ›*g ˆ,‚„˙  ‚˙˙˙g ›*$ ‘+‚„˙ Œ˙1)‚Ě˙‚ ˙˙˙˙˙˙˙g ‘+$ ˆ,‚„˙ Œ˙2)‚Ě˙‚ ˙˙˙˙˙˙˙˙Nƒ Licenseƒ License_dateƒLicense_agency˙˙˙f ")T ")‚„˙  ‚˙˙˙˙ć*ý N,‚„˙ Œ˙41Agencies may test your skills before hiring you.‚˙˙˙ Â*ů Â*‚„˙  ‚˙˙ ^,ű ^,‚„˙  ‚˙˙ű Â*ű h,‚„˙  ‚˙˙Q–,‚˜.‚Other_language„˙ ‚ ö‚–,“-˜.Bö–,‚;-‚ Speak_read„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ôƒ;-„Ů×Do you speak or read another language (including sign language)? Click "YES" if you speak or read another language and list each language below. Click "NO" if you do not speak or read another language and go to 36.…†˙˙‡˙˙ö“-‚8.‚ Speak_read„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚őƒ8.„Ů×Do you speak or read another language (including sign language)? Click "YES" if you speak or read another language and list each language below. Click "NO" if you do not speak or read another language and go to 36.…†˙˙‡˙˙ö–,ö˜.‚„˙  ‚˙˙˙‚–,‚˜.‚„˙  ‚˙˙˙ö–,‚–,‚„˙  ‚˙˙˙ö“-‚“-‚„˙  ‚˙˙˙ö˜.‚˜.‚„˙  ‚˙˙˙˙RQ–,ö–,‚„˙  ‚˙˙˙Q“-ö“-‚„˙  ‚˙˙˙Q˜.ö˜.‚„˙  ‚˙˙˙Q–,Q˜.‚„˙  ‚˙˙˙Q–,ö“-‚„˙ Œ˙YES‚É˙‚ ˙˙˙˙˙˙˙Q“-ö˜.‚„˙ Œ˙NO‚É˙‚ ˙˙˙˙˙˙˙˙Nƒ Speak_read˙˙˙A–,0.Ř-‚„˙ Œ˙URIf "YES", list each language and place an "X" in each column that applies to you.‚™˙AŘ-o"Ş.‚„˙ Œ˙If "NO", go to 36.‚™˙x00.2‚Language_fluency„˙ ‚ĂůŁ#ą1 ż#L'Í*0.x0B12BĂx0ůB1‚ Language„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚öƒB1„omList other languages you speak or read fluently. Then check the boxes on the right relating to your fluency.…†˙˙‡˙˙ĂB1ů2‚ Language„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙˙˙‚÷ƒ2„omList other languages you speak or read fluently. Then check the boxes on the right relating to your fluency.…†˙˙‡˙˙ůx0Ł,1‚Lectures_fluent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚řƒ,1„GEClick if you can prepare and give lectures in this language fluently.…†˙˙‡˙˙ůB1Łö1‚Lectures_fluent„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ůƒö1„GEClick if you can prepare and give lectures in this language fluently.…†˙˙‡˙˙Łx0#,1‚Lectures_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚úƒ,1„NLClick if you can prepare and give lectures in this language with difficulty.…†˙˙‡˙˙ŁB1#ö1‚Lectures_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚űƒö1„NLClick if you can prepare and give lectures in this language with difficulty.…†˙˙‡˙˙#x0ą,1‚Speak_fluently„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚üƒ,1„@>Click if you can speak and understand this language fluently.…†˙˙‡˙˙#B1ąö1‚Speak_fluently„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ýƒö1„@>Click if you can speak and understand this language fluently.…†˙˙‡˙˙ąx01 ,1‚Speak_passably„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ţƒ,1„@>Click if you can speak and understand this language passably.…†˙˙‡˙˙ąB11 ö1‚Speak_passably„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚˙ƒö1„@>Click if you can speak and understand this language passably.…†˙˙‡˙˙1 x0ż#,1‚ Into_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„=;Click if you can translate into english from this language.…†˙˙‡˙˙1 B1ż#ö1‚ Into_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„=;Click if you can translate into english from this language.…†˙˙‡˙˙ż#x0L',1‚ From_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„=;Click if you can translate from english into this language.…†˙˙‡˙˙ż#B1L'ö1‚ From_english„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„=;Click if you can translate from english into this language.…†˙˙‡˙˙L'x0Í*,1‚ Read_easily„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„JHClick if you can read articles in this language for your own use easily.…†˙˙‡˙˙L'B1Í*ö1‚ Read_easily„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„JHClick if you can read articles in this language for your own use easily.…†˙˙‡˙˙Í*x00.,1‚Read_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒ,1„SQClick if you can read articles in this language for your own use with difficulty.…†˙˙‡˙˙Í*B10.ö1‚Read_difficulty„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Œ˙‚ƒ˙˙‚ƒö1„SQClick if you can read articles in this language for your own use with difficulty.…†˙˙‡˙˙Ăx0Ă2‚„˙  ‚˙˙˙ůx0ů2‚„˙  ‚˙˙˙Łx0Ł2‚„˙  ‚˙˙˙#x0#2‚„˙  ‚˙˙˙ąx0ą2‚„˙  ‚˙˙˙1 x01 2‚„˙  ‚˙˙˙ż#x0ż#2‚„˙  ‚˙˙˙L'x0L'2‚„˙  ‚˙˙˙Í*x0Í*2‚„˙  ‚˙˙˙0.x00.2‚„˙  ‚˙˙˙Ăx00.x0‚„˙  ‚˙˙˙ĂB10.B1‚„˙  ‚˙˙˙Ă20.2‚„˙  ‚˙˙˙˙Rx0Ăx0‚„˙  ‚˙˙˙B1ĂB1‚„˙  ‚˙˙˙2Ă2‚„˙  ‚˙˙˙x02‚„˙  ‚˙˙˙x0ĂB1‚„˙ Œ˙1)‚ť˙‚ ˙˙˙˙˙˙˙B1Ă2‚„˙ Œ˙2)‚ť˙‚ ˙˙˙˙˙˙˙˙Nƒ LanguageƒLectures_fluentƒLectures_difficultyƒSpeak_fluentlyƒSpeak_passablyƒ Into_englishƒ From_englishƒ Read_easilyƒRead_difficulty˙˙˙ œ.0.œ.‚„˙ ‚˙˙'p/ůN0‚„˙ Œ˙ LANGUAGE(S)‚˙˙˙Ř/0.Ř/‚„˙  ‚˙˙Ô/‡|0‚„˙ x˙  Fluently‚˙˙˙#˘.# 1‚„˙  ‚˙˙Łâ/ŁŹ0‚„˙  ‚˙˙1 ˘.1 1‚„˙  ‚˙˙M'œ.M' 1‚„˙  ‚˙˙´Ô/ˆ0‚„˙ x˙ With Difficulty‚˙˙˙Ś.đ/‚„˙ x˙!CAN PREPARE AND GIVE LECTURES‚˙˙˙ůš.ů1‚„˙  ‚˙˙?Ś. đ/‚„˙ x˙CAN SPEAK AND UNDERSTAND‚˙˙˙[Ô/‡Š0‚„˙ x˙  Fluently‚˙˙˙ąâ/ąž0‚„˙  ‚˙˙ŰÔ/ ˆ0‚„˙ x˙  Passably‚˙˙˙? Ô/Ł#Š0‚„˙ x˙ Into English‚˙˙˙ż#Ú/ż#ž0‚„˙  ‚˙˙Ű#Ô/?'ˆ0‚„˙ x˙ From English‚˙˙˙? Ś.?'đ/‚„˙ x˙CAN SPEAK AND UNDERSTAND‚˙˙˙i'Ô/ą*˜0‚„˙ x˙ Easily‚˙˙˙Í*Ü/Í*0‚„˙  ‚˙˙Ű*Ô/#.Š0‚„˙ x˙With Difficulty‚˙˙˙i'Ś.1.đ/‚„˙ x˙!CAN READ ARTICLES FOR OWN USE‚˙˙˙ 2c2‚„˙  ‚˙˙´ 2#.3‚„˙ ‚˙‚ ˙˙˙ş 2ż3‚„˙ ˙˙˙Č˙ REFERENCES‚˙˙˙3‰-œ4‚„˙ Œ˙ýList three people who are not related to you and are not supervisors you listed under B24B who know your qualifications and fitness for the kind of job for which you are applying. At least BoneB should know you well on a personal basis.‚˙˙˙4 .,;‚ References„˙ ‚_]&‹( .ý5Č7z9,;Bý5Č7‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ƒČ7„(&Enter the full name of your reference.…†˙˙‡˙˙Č7z9‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒz9„(&Enter the full name of your reference.…†˙˙‡˙˙z9,;‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒ,;„(&Enter the full name of your reference.…†˙˙‡˙˙ý5_Č7‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒČ7„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙Č7_z9‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒz9„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙z9_,;‚Phone„˙ ‚˙‚ ˙˙˙˙˙˙˙ €´˙˙˙‚ ƒ,;„CAEnter the phone number of this reference (include the area code).…†˙˙‡˙˙_ý5]&Č7‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒČ7„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙_Č7]&z9‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒz9„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙_z9]&,;‚ Address„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙˙‚˙˙‚ƒ,;„ťšEnter the business or home address of this reference. You may use the Format Toolbar in Formatta Filler to reduce the font size if the address is too long to fit in the space provided.…†˙˙‡˙˙]&ý5‹(Č7‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒČ7„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙]&Č7‹(z9‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒz9„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙]&z9‹(,;‚State„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ,;„SQEnter the two letter abbreviation for the state of the address of this reference.…†˙˙‡˙˙‹(ý5 .Č7‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒČ7„75Enter the zip code for the address of this reference.…†˙˙‡˙˙‹(Č7 .z9‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒz9„75Enter the zip code for the address of this reference.…†˙˙‡˙˙‹(z9 .,;‚Zip„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒ,;„75Enter the zip code for the address of this reference.…†˙˙‡˙˙ý5,;‚„˙  ‚˙˙˙ý5,;‚„˙  ‚˙˙˙_ý5_,;‚„˙  ‚˙˙˙]&ý5]&,;‚„˙  ‚˙˙˙‹(ý5‹(,;‚„˙  ‚˙˙˙ .ý5 .,;‚„˙  ‚˙˙˙ý5 .ý5‚„˙  ‚˙˙˙Č7 .Č7‚„˙  ‚˙˙˙z9 .z9‚„˙  ‚˙˙˙,; .,;‚„˙  ‚˙˙˙˙C4ý5‚„˙  ‚˙˙˙4ý5‚„˙  ‚˙˙˙_4_ý5‚„˙  ‚˙˙˙]&4]&ý5‚„˙  ‚˙˙˙‹(4‹(ý5‚„˙  ‚˙˙˙ .4 .ý5‚„˙  ‚˙˙˙4 .4‚„˙  ‚˙˙˙4ý5‚„˙ Œ˙FULL NAME OF REFERENCE‚˙˙‚ ˙˙˙˙˙˙˙4_ý5‚„˙ Œ˙-*TELEPHONE NUMBER(S) ( Include Area Code )‚“˙‚ ˙˙˙˙˙˙˙_4]&ý5‚„˙ Œ˙@=PRESENT BUSINESS OR HOME ADDRESS ( Number, street and city )‚“˙‚ ˙˙˙˙˙˙˙]&4‹(ý5‚„˙ Œ˙ STATE‚˙˙‚ ˙˙˙˙˙˙˙‹(4 .ý5‚„˙ Œ˙  ZIP CODE‚˙˙‚ ˙˙˙˙˙˙˙˙Rý5ý5‚„˙  ‚˙˙˙Č7Č7‚„˙  ‚˙˙˙z9z9‚„˙  ‚˙˙˙,;,;‚„˙  ‚˙˙˙ý5,;‚„˙  ‚˙˙˙ý5Č7‚„˙ Œ˙1)‚Œ˙‚ ˙˙˙˙˙˙˙Č7z9‚„˙ Œ˙2)‚Œ˙‚ ˙˙˙˙˙˙˙z9,;‚„˙ Œ˙3)‚Œ˙‚ ˙˙˙˙˙˙˙˙NƒNameƒPhoneƒ AddressƒStateƒZip˙˙˙˛&;ž|<‚„˙ Œ˙PPage 3P˙‚˙˙˙”4G”4‚„˙  ‚˙˙ ř A"’ ‚„˙ Œ˙To‚˙˙˙i"ř Ă$’ ‚„˙ x˙  Semester‚˙˙˙Ľ,!.ä‚„˙ Œ˙No‚˙˙˙ §Ü‚„˙ Œ˙To‚˙˙˙_n^j‚ School1_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒj„86Enter the name of the first other school you attended.…†˙˙‡˙_ZaV‚ School1_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒV„86Enter the city of the first other school you attended.…†˙˙‡˙Z‰T‚School1_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒT„97Enter the state of the first other school you attended.…†˙˙‡˙ˇZUR‚ School1_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ƒR„<:Enter the zip code of the first other school you attended.…†˙˙‡˙Az"ď-š'‚Skillsandawardsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚ ƒš'…†˙˙‡˙+â)ŽŽ*‚ Typing_speedƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚!ƒŽ*„)'How many words per minute can you type?…†˙˙‡˙câ)ĺŽ*‚Dictation_speedsƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚"ƒŽ*„" How fast can you take dictation?…†˙˙‡˙ŇĐ (‚„˙ Œ˙ Pň25P˙‚˙˙˙Îl Ä ‚„˙ Œ˙ Pň28P˙‚˙˙˙AĚ|$‚„˙ Œ˙ Pň26P˙‚˙˙˙>`y¸‚„˙ Œ˙ Pň27P˙‚˙˙˙Ń r‚„˙ Œ˙ Pň29P˙‚˙˙˙Sv‚„˙ Œ˙ Pň30P˙‚˙˙˙Đ¤ ü‚„˙ Œ˙ Pň31P˙‚˙˙˙Đ< ”"‚„˙ Œ˙ Pň32P˙‚˙˙˙Đœ' ô)‚„˙ Œ˙ Pň33P˙‚˙˙˙ú š'5 ň)‚„˙ Œ˙ Pň34P˙‚˙˙˙ĐŒ, ä.‚„˙ Œ˙ Pň35P˙‚˙˙˙Đ$3 |5‚„˙ Œ˙ Pň36P˙‚˙˙˙¤č„Ö‚ Hsgrad_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚#ƒÖ„[YEnter the month and year you graduated from high school or received your GED equivalency.…†˙˙‡˙žň„ŕ‚Highest_grade_completedƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚$ƒŕ…†˙˙‡˙dDr0‚ School2_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚tƒ0„97Enter the name of the second other school you attended.…†˙˙‡˙df‚ School2_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚uƒ„97Enter the city of the second other school you attended.…†˙˙‡˙„Š‚School2_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚vƒ„:8Enter the state of the second other school you attended.…†˙˙‡˙ŽL‚ School2_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚wƒ„=;Enter the zip code of the second other school you attended.…†˙˙‡˙F[ .l‚Explanation1_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Rƒl…†˙˙‡˙FŐ .ć ‚Explanation2_nameƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚yƒć …†˙˙‡˙FZ' ‚Explanation1_addressƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Sƒ …†˙˙‡˙BŒ!V'ˆ"‚Explanation2_cityƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚zƒˆ"…†˙˙‡˙0)‹! .|"‚Explanation2_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚|ƒ|"…†˙˙‡˙0)!.‚Explanation1_zipƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Uƒ…†˙˙‡˙ôHx)V‚Citizenship_countryƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚xƒV…†˙˙‡˙c*Ş".´'‚„˙  ‚˙‚ €€€˙˙˙˙˙˙§".§"‚„˙  ‚˙˙p*ĺ '.ŕ‚„˙  ‚˙‚ €€€˙˙˙˙˙˙b*°".€$‚Federal_retirement„˙ ‚ b*I,. #€$Bb* #I,r$‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚%ƒr$„­ŤClick "Yes" if you receive, or have ever applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service.…†˙˙‡˙˙I, #.r$‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚&ƒr$„ľłClick "No" if you do NOT receive, and have NEVER applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service.…†˙˙‡˙˙b* #b*€$‚„˙  ‚˙˙˙I, #I,€$‚„˙  ‚˙˙˙. #.€$‚„˙  ‚˙˙˙b* #. #‚„˙  ‚˙˙˙b*€$.€$‚„˙  ‚˙˙˙˙Cb*°"b* #‚„˙  ‚˙˙˙I,°"I, #‚„˙  ‚˙˙˙.°". #‚„˙  ‚˙˙˙b*°".°"‚„˙  ‚˙˙˙b*°"I, #‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙I,°". #‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙#.a‚„˙ Œ˙Mailing Address‚˙˙˙Ŕs. ‚„˙ (‚˙‚ ˙˙˙˙˙˙ŻŽ(.Ä‚„˙ ‚˙‚ ˙˙˙Č¸Ď-Ć‚„˙ ˙˙˙Č˙}z BACKGROUND INFORMATION - PśYou must answer each question in this section before we can process your application.P˙‚˙˙˙8Ń9%W‚„˙ Œ˙ţűAre you a citizen of the United States? ( In most cases you must be a U.S. citizen to be hired. You will be required to submit proof of identity and citizenship at the time you are hired. ) If "NO", give the country or countries you are a citizen of:‚˙˙˙p*¸(.j‚ Us_citizen„˙ ‚ p*W,(.šjBp*šW,j‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚'ƒj„&$Click "Yes" if you are a US Citizen.…†˙˙‡˙˙W,š(.j‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚(ƒj„›™Click "No" if you are not a US citizen. If you are not a citizen, in the adjacent blank, fill out the country (or countries) of which you are a citizen.…†˙˙‡˙˙p*šp*j‚„˙  ‚˙˙˙W,šW,j‚„˙  ‚˙˙˙(.š(.j‚„˙  ‚˙˙˙p*š(.š‚„˙  ‚˙˙˙p*j(.j‚„˙  ‚˙˙˙˙Cp*¸p*š‚„˙  ‚˙˙˙W,¸W,š‚„˙  ‚˙˙˙(.¸(.š‚„˙  ‚˙˙˙p*¸(.¸‚„˙  ‚˙˙˙p*¸W,š‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙W,¸(.š‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙ăć-9 ‚„˙ Œ˙BNOTE: It is important that you give complete and truthful answers to questions 38 through 44. B If you answer B"YES"B to any of them, provide your explanation(s) in BItem 45. IncludeB convictions resulting from a plea of nolo contendere ( no contest ). BOmit:B 1) traffic fines of $ 100.00 or less; 2) any violation of law committed before your 16th birthday; 3) any violation of law committed before your 18th birthday, if finally decided in juvenile court or under a Youth Offender law; 4) any conviction set aside under the Federal Youth Corrections Act or similar State law; 5) any conviction whose record was expunged under Federal or State law. We will consider the date, facts and circumstances of each event you list. In most cases you can still be considered for Federal jobs. However,B if you fail to tell the truth or fail to list all relevant Bevents or circumstances, this may be grounds for not hiring you, for firing you after you begin work, or for criminal prosecution (18 USC 1001).‚˙˙˙o* '.Ô ‚ Quit_fired„˙ ‚ o*V,'.ţ Ô Bo*ţ V,Đ ‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚)ƒĐ „šˇClick "Yes" if, in the last 10 years, you were fired from any job for any reason, quit after being told you were fired, or left a job by mutual agreement because of specific problems.…†˙˙‡˙˙V,ţ '.Đ ‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚*ƒĐ „ÍËClick "No" if, in the last 10 years, you were NOT fired from any job for any reason, did NOT quit after being told you were fired, or did NOT leave a job by mutual agreement because of specific problems.…†˙˙‡˙˙o*ţ o*Ô ‚„˙  ‚˙˙˙V,ţ V,Ô ‚„˙  ‚˙˙˙'.ţ '.Ô ‚„˙  ‚˙˙˙o*ţ '.ţ ‚„˙  ‚˙˙˙o*Ô '.Ô ‚„˙  ‚˙˙˙˙Co* o*ţ ‚„˙  ‚˙˙˙V, V,ţ ‚„˙  ‚˙˙˙'. '.ţ ‚„˙  ‚˙˙˙o* '. ‚„˙  ‚˙˙˙o* V,ţ ‚„˙ Č˙Yes‚˙˙˙‚ ˙˙˙˙˙˙˙V, '.ţ ‚„˙ Č˙No‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒYesƒNo˙˙˙b; *Á ‚„˙ Œ˙ĂŔDuring the last 10 years, were you fired from any job for any reason, did you quit after being told that you would be fired, or did you leave by mutual agreement because of specific problems?‚˙˙˙_Ď ‡*Ď ‚„˙  ‚˙˙b c%E‚„˙ Œ˙:7Have you ever been convicted of, or forfeited collateral for any felony violation? ( Generally, a felony is defined as any violation of law punishable by imprisonment of longer than one year, except for violations called misdemeanors under State law which are punishable by imprisonment of two years or less. )‚˙˙˙o*p'.h‚Background_39to41„˙ ‚o*V,'.plthBo*pV,B‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚+ƒB„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*lV,>‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚,ƒ>„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*tV,F‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚-ƒF„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙V,p'.B‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚.ƒB„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,l'.>‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚/ƒ>„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,t'.F‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚0ƒF„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙o*po*h‚„˙  ‚˙˙˙V,pV,h‚„˙  ‚˙˙˙'.p'.h‚„˙  ‚˙˙˙o*p'.p‚„˙  ‚˙˙˙o*l'.l‚„˙  ‚˙˙˙o*t'.t‚„˙  ‚˙˙˙o*h'.h‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_o‡*o‚„˙  ‚˙˙_•`%g‚„˙ Œ˙74Are you now under charges for any violation of law?‚˙˙˙_m‡*m‚„˙  ‚˙˙o*('.$‚Background_42to43„˙ ‚ o*V,'.("$Bo*(V,ú‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚1ƒú„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙o*"V,ô‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚2ƒô„86Click "Yes" if the questions on the left apply to you.…†˙˙‡˙˙V,('.ú‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚3ƒú„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙V,"'.ô‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚4ƒô„><Click "No" if the questions on the left do NOT apply to you.…†˙˙‡˙˙o*(o*$‚„˙  ‚˙˙˙V,(V,$‚„˙  ‚˙˙˙'.('.$‚„˙  ‚˙˙˙o*('.(‚„˙  ‚˙˙˙o*"'."‚„˙  ‚˙˙˙o*$'.$‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_‘`%‚„˙ Œ˙ŇĎDuring the Blast 10 yearsB have you forfeited collateral, been convicted, been imprisoned, been on probation, or been on parole? Do Bnot Binclude violations reported in 39, 40, or 41, above.‚˙˙˙_'‡*'‚„˙  ‚˙˙_C`%‚„˙ Œ˙urHave you BeverB been convicted by a military Bcourt-martial?B If no military service, answer "NO"‚˙˙˙_#‡*#‚„˙  ‚˙˙p*č(.ä‚Background_44„˙ ‚ p*W,(.čäBp*čW,ş‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚5ƒş„íëClick "Yes" if you are deliquent on any federal debt, including taxes, loans, overpayment of benefits, and other debts to the U.S. Governmenet, PLUS defaults on Federally guaraneteed or insured loans such as student and mortgage loans.…†˙˙‡˙˙W,č(.ş‚No„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚6ƒş„îěClick "No" if you are NOT deliquent on any federal debt, including taxes, loans, overpayment of benefits, and other debts to the U.S. Governmenet, OR defaults on Federally guaraneteed or insured loans such as student and mortgage loans.…†˙˙‡˙˙p*čp*ä‚„˙  ‚˙˙˙W,čW,ä‚„˙  ‚˙˙˙(.č(.ä‚„˙  ‚˙˙˙p*č(.č‚„˙  ‚˙˙˙p*ä(.ä‚„˙  ‚˙˙˙˙NƒYesƒNo˙˙˙_M%Ó‚„˙ Œ˙Are you delinquent on any Federal debt? ( Include delinquencies arising from Federal taxes, loans, overpayment of benefits, and other debts to the U.S. Government BplusB defaults on Federally guaranteed or insured loans such as student and home mortgage loans.)‚˙˙˙_ă‡*ă‚„˙  ‚˙˙_™`%k‚„˙ Œ˙zwHave you BeverB been convicted of, or forfeited collateral for anyB firearms or explosives violation?B‚˙˙˙_q‡*q‚„˙  ‚˙˙3+˝‚„˙ Œ˙?<B38 - BExplain for each job the problem(s) and your reason(s) for leaving. Give the employer's name and address. B39 through 43 -B Explain each violation. Give place of occurrence and name/address of police or court involved. B44 -B Explain the type, length and amount of the delinquency or default. and steps you are taking to correct errors or repay the debt. Give any identification number associated with the debt and the address of the Federal agency involved. If you need more space, use a sheet of paper, and include the item number.‚˙˙˙_§"‚Explanation_38to44„˙ ‚_sť­Ő(N z!§"B_­sŐ‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚7ƒŐ…†˙˙‡˙˙_Ős‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚8ƒ…†˙˙‡˙˙_s(‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚9ƒ(…†˙˙‡˙˙_(sN ‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚:ƒN …†˙˙‡˙˙_N sz!‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚;ƒz!…†˙˙‡˙˙_z!s§"‚ Item_number„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ˙˙˙˙0˙ ˙˙˙˙-0˙„˙˙˙˙‚<ƒ§"…†˙˙‡˙˙s­ťŐ‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚=ƒŐ„*(Give the month and year of the incident.…†˙˙‡˙˙sŐť‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚>ƒ„*(Give the month and year of the incident.…†˙˙‡˙˙sť(‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚?ƒ(„*(Give the month and year of the incident.…†˙˙‡˙˙s(ťN ‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚@ƒN „*(Give the month and year of the incident.…†˙˙‡˙˙sN ťz!‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Aƒz!„*(Give the month and year of the incident.…†˙˙‡˙˙sz!ť§"‚Date„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Bƒ§"„*(Give the month and year of the incident.…†˙˙‡˙˙ť­Ő‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚CƒŐ„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťŐ‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Dƒ„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ť(‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Eƒ(„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ť(N ‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚FƒN „öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťN z!‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Gƒz!„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙ťz!§"‚ Explanation„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙‚˙˙‚Hƒ§"„öôGive your explanation for the incident. Follow the rules listed above for details on what you should cover in your explanation. If there is not enough space, use an additional sheet of paper, listing the item number along with you explanation.…†˙˙‡˙˙_­_§"‚„˙ ‚˙˙˙s­s§"‚„˙ ‚˙˙˙ť­ť§"‚„˙ ‚˙˙˙­§"‚„˙ ‚˙˙˙_­­‚„˙ ‚˙˙˙_ŐŐ‚„˙ ‚˙˙˙_‚„˙ ‚˙˙˙_((‚„˙ ‚˙˙˙_N N ‚„˙ ‚˙˙˙_z!z!‚„˙ ‚˙˙˙_§"§"‚„˙ ‚˙˙˙˙C__­‚„˙ ‚˙˙˙ss­‚„˙ ‚˙˙˙ťť­‚„˙ ‚˙˙˙­‚„˙ ‚˙˙˙_‚„˙ ‚˙˙˙_s­‚„˙ Œ˙  Item No.‚˙˙˙‚ ˙˙˙˙˙˙˙sť­‚„˙ Œ˙Date (Mo./Yr.)‚˙˙˙‚ ˙˙˙˙˙˙˙ť­‚„˙ Œ˙ Explanation‚˙‚ ˙˙˙˙˙˙˙˙Nƒ Item_numberƒDateƒ Explanation˙˙˙!.‚„˙  ‚˙˙$Ž!.Ž‚„˙  ‚˙˙+ľó+•‚„˙ Œ˙63Name of Employer, Police, Court, or Federal Agency‚˙˙˙'.'‚„˙  ‚˙˙+u.u‚„˙  ‚˙˙+ui G‚„˙ Œ˙City‚˙˙˙w'uľ)G‚„˙ Œ˙ State‚˙˙˙N)tŒ+F‚„˙ Œ˙Zip‚˙˙˙+'ó+ ‚„˙ Œ˙63Name of Employer, Police, Court, or Federal Agency‚˙˙˙ç .ç ‚„˙  ‚˙˙+ç i š!‚„˙ Œ˙City‚˙˙˙w'ç ľ)š!‚„˙ Œ˙ State‚˙˙˙@)ć ~+¸!‚„˙ Œ˙Zip‚˙˙˙bÓ"ƒ$Y$‚„˙ Œ˙§¤Do you receive, or have you ever applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service?‚˙˙˙_u$‡*u$‚„˙  ‚˙˙_Ą$€$'‚„˙ Œ˙ćăDo any of your relatives work for the United States Government or the United States Armed Forces? Include: father; mother; husband; wife; son; daughter; brother; sister; uncle; aunt; first cousin; nephew; niece; father-in-law; mother-in-law; son-in-law; daughter-in-law; brother-in-law; sister-in-law; stepfather; stepmother; stepson; stepdaughter; stepbrother; stepsister; half brother; and half sister If "YES", provide details below. If you need more space, use a sheet of paper.‚˙˙˙_Ą'‡*Ą'‚„˙  ‚˙˙_Ś'!.–-‚Listing_of_relatives„˙ ‚_Îę!.“(:*ĺ+–-B_“(Î:*‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Iƒ:*…†˙˙‡˙˙_:*Îĺ+‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Jƒĺ+…†˙˙‡˙˙_ĺ+Ζ-‚Name„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Kƒ–-…†˙˙‡˙˙Î“(ę:*‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Lƒ:*„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙Î:*ęĺ+‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Mƒĺ+„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙Îĺ+ę–-‚ Relationship„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Nƒ–-„VTEnter your relationship with this relative. See above for listing of relationships.…†˙˙‡˙˙ę“(!.:*‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Oƒ:*„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙ę:*!.ĺ+‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Pƒĺ+„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙ęĺ+!.–-‚ Department„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Ü˙˙˙‚Qƒ–-„a_Enter the department, agency, or branch of the armed forces in which your relative is employed.…†˙˙‡˙˙_“(_–-‚„˙ ‚˙˙˙Î“(Ζ-‚„˙ ‚˙˙˙ę“(ę–-‚„˙ ‚˙˙˙!.“(!.–-‚„˙ ‚˙˙˙_“(!.“(‚„˙ ‚˙˙˙_:*!.:*‚„˙ ‚˙˙˙_ĺ+!.ĺ+‚„˙ ‚˙˙˙_–-!.–-‚„˙ ‚˙˙˙˙C_Ś'_“(‚„˙ ‚˙˙˙ÎŚ'Γ(‚„˙ ‚˙˙˙ęŚ'ę“(‚„˙ ‚˙˙˙!.Ś'!.“(‚„˙ ‚˙˙˙_Ś'!.Ś'‚„˙ ‚˙˙˙_Ś'Ζ(‚„˙ Œ˙P˘NameP˙‚˙˙˙‚ ˙˙˙˙˙˙˙ÎŚ'ę“(‚„˙  ˙ Relationship‚˙˙˙‚ ˙˙˙˙˙˙˙ęŚ'!.“(‚„˙  ˙0-Department, Agency or Branch of Armed Forces‚˙˙˙‚ ˙˙˙˙˙˙˙˙NƒNameƒ Relationshipƒ Department˙˙˙Ăœ-!.Ą.‚„˙ ‚˙‚ ˙˙˙ÉŚ-y´.‚„˙ ˙˙˙Č˙96 SIGNATURE, CERTIFICATION, AND RELEASE OF INFORMATION‚˙˙˙E/ń(q0‚„˙ Ü˙ROYOU MUST SIGN THIS APPLICATION. Read the following carefully before you sign.‚˙˙˙_Ă0§)6‚„˙ Œ˙ŕÝA false statement on any part of your application may be grounds for not hiring you, or for firing you after you begin work. Also, you may be punished by fine or imprisonment (U.S. Code, title 18, section 1001). If you are a male born after December 31, 1959 you must be registered with the Selective Service System or have a valid exemption in order to be eligible for Federal employment. You will be required to certify as to your status at the time of appointment. I understand that any information I give may be investigated as allowed by law or Presidential order. I consent to the release of information about my ability and fitness for Federal employment by employers, schools, law enforcement agencies and other individuals and organizations, to investigators, personnel staffing specialists, and other authorized employees of the Federal Government. I certify that, to the best of my knowledge and belief, all of my statements are true, correct, complete, and made in good faith.‚˙˙˙_7.7‚„˙ (‚˙˙_)7çű7‚„˙ Œ˙30Signature ( Sign each application in dark ink )‚˙˙˙-!)7ĺ+ű7‚„˙ Œ˙.+BDATE SIGNED ( Month, day, year )B‚˙˙˙`q:!.q:‚„˙ (‚˙˙É0;ľ˜<‚„˙ Œ˙PPage 4P˙‚˙˙˙ˆ'ô( ‚Explanation1_stateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Tƒ …†˙˙‡˙Ľœ8ł×9‚Applicant_signatureƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙˙˙‚Zƒ×9…†˙˙‡˙Ő!œ8Í*×9‚Signature_dateƒ Text_field„˙ ‚˙‚ ˙˙˙˙˙˙˙ €Č˙ ‚ mmmm d, yyyyƒ˙˙‚[ƒ×9…†˙˙‡˙b*á%.˘'‚ Gov_relative„˙  ‚ b*I,.Ë&˘'Bb*Ë&I,'‚Yes„˙ ‚˙‚ ˙˙˙˙˙˙˙ € ˙‚ƒ˙˙‚\ƒ'„¤˘Click "Yes" if you have any relatives who work for the United States Government or the United States Armed Forces. 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