Sf 171 Form - Application For Federal Employment Page 3
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4Bureau of Indian Affairs Water Resources Technician Training Program Spring / Summer for American Indians and Alaska Natives
ATTACH ANY ADDITIONAL FORMS AND SHEETS HERE
EDUCATION
Did you graduate from high school? If you have a GED high school
Write the name and location (city and state) of the last high school you attended or
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5
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6
equivalency or will graduate within the next nine months, answer "YES ".
where you obtained your GED high school equivalency.
If "YES", give month and year graduated
YES
Have you ever attended
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YES
If "YES ", continue with 28.
or received GED equivalency:
college or graduate
NO
If "NO", give the highest grade you completed:
If "NO ", go to 31 .
NO
school?
NAME AND LOCATION (city, state and ZIP Code) OF COLLEGE OR UNIVERSITY. If you expect to grad-
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TYPE OF
MONTH
MONTH AND YEAR
NUMBER OF CREDIT
DEGREE
AND
uate within nine months, give the month and year you expect to receive your degree:
ATTENDED
HOURS COMPLETED
(e.g. B.A.,
YEAR OF
Name
City
State
ZIP Code
From
To
Semester Quarter
M.A.)
DEGREE
1)
2)
3)
2
9
3
0
NUMBER OF CREDIT
NUMBER OF CREDIT
CHIEF UNDERGRADUATE SUBJECTS
CHIEF GRADUATE SUBJECTS
HOURS COMPLETED
HOURS COMPLETED
Show major on the first line
Show major on the first line
Semester
Quarter
Semester
Quarter
1)
1)
2)
2)
3)
3)
If you have completed any other courses or training related to the kind of jobs you are applying for (trade, vocational, Armed Forces, business) give information below.
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MONTH AND YEAR
TRAINING
NAME AND LOCATION (city, state and ZIP Code) OF SCHOOL
CLASS-
COMPLETED
ATTENDED
ROOM
SUBJECT(S)
From
To
HOURS
YES
NO
School Name
1)
City
State ZIP Code
School Name
2)
City
State ZIP Code
SPECIAL SKILLS, ACCOMPLISHMENTS AND AWARDS
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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.
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How many words per
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List job-related licenses or certificates that you have, such as: registered nurse; lawyer; radio operator; driver's; pilot's; etc.
minute can you:
DATE OF LATEST LICENSE
STATE OR OTHER
LICENSE OR CERTIFICATE
TYPE? TAKE DICTATION?
OR CERTIFICATE
LICENSING AGENCY
1)
Agencies may test your
skills before hiring you.
2)
Do you speak or read a language other than English (include sign
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YES
If "YES", list each language and place an "X" in each column that applies to you.
language) ? Applicants for jobs that require a language other than
If "NO", go to 36.
NO
English may be given an interview conducted solely in that language.
CAN PREPARE AND
CAN READ ARTICLES
CAN SPEAK AND UNDERSTAND
CAN TRANSLATE ARTICLES
LANGUAGE(S)
FOR OWN USE
GIVE LECTURES
Fluently
With Difficulty
Fluently
Passably
Into English
From English
Easily
With Difficulty
1)
2)
R E F E R E N C E S
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List three people who are not related to you and are not supervisors you listed under 24 who know your qualifications and fitness for the kind of job for which you are applying.
At least one should know you well on a personal basis.
TELEPHONE NUMBER(S)
PRESENT BUSINESS OR HOME ADDRESS
FULL NAME OF REFERENCE
STATE
ZIP CODE
(Include Area Code)
(Number, street and city)
1)
2)
3)
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