Cicity Of Medford Veteran'S Preference Form (Page 2 of 2) in pdf

For Office Use Only

City of Medford

Date Received:____________________

Veteran’s Preference Form

Received By:_____________________

Under Oregon law, veterans who meet minimum qualifications for a position may be eligible for employment

preference. If you think you may qualify, please read the following checklist carefully. Check the box for each item

that is appropriate. If you need further explanation or have special circumstances, please call Human Resources at

541-774-2010.

This completed form and the required documentation must be submitted to the City of Medford Human Resources

Department at the time you submit your application.

A. QUALIFIED VETERAN QUESTIONS: You may claim veteran’s preference if you check at least one box in

the four sections below and provide proof of eligibility by submitting a copy of your (long form) DD-214 or

215 and Certificate of Honorable Discharge.

ORS 408.225 (1)(e)

I served on active duty with the Armed Forces of the United States for period of more than 178 consecutive

days and was discharged or released under honorable conditions; or

I served on active duty with the Armed Forces of the United States for 178 days or less and was discharged

or released from active duty under honorable conditions because of a service-connected disability, or

I served on active duty with the Armed Forces of the United States for at least one day in a combat zone

and was discharged or released from active duty under honorable conditions; or

I received a combat or campaign ribbon for service in the Armed Forces of the United States.

“Active duty” does not include attendance at a school under military orders, except schooling incident to an active

enlistment or a regular tour of duty, or normal military training as a reserve officer or member of an organized

reserve or a National Guard unit.

B. QUALIFIED DISABLED VETERAN QUESTIONS: You may claim additional employment preference if you

can check at least one box in three sections below and provide proof of eligibility by submitting all three

documents listed below:

1. A copy of your (long form) DD-214 or 215 and

2. Certificate of Honorable Discharge and

3. A public employment preference letter from the United States Department of Veterans Affairs.

ORS 408.225 (1)(c)

I am entitled to disability compensation under laws administered by the United States Department of

Veterans Affairs; or

I was discharged or released from active duty for a disability incurred or aggravated in the line of duty; or

I was awarded the Purple Heart for wounds received in combat.

I hereby claim veteran’s preference points and certify that the above information is true and correct. I understand

that any false statements may be cause for my disqualification or dismissal, regardless of when discovered.

______________________________________

________________________

Print Name

Date

_________________________________________

Signature

Position Applied For:______________________________________________________

Preference will not be awarded without the appropriate documentation. You must submit your (long form) DD-214

or 215 and Certificate of Honorable Discharge in all cases. If you are claiming disabled veteran points, you must

also submit the public employment preference letter from the Department of Veterans Affairs. You will not receive

preference without these accompanying documents.

Cicity Of Medford Veteran'S Preference Form Page 2

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