State of Florida
F O R
O F F I C I A L
U S E
O N L Y
EMPLOYMENT
APPLICATION
Agency Authorized Signature
Date
Class Code
Status
P O S I T I O N
A P P L I E D
F O R
Equal Opportunity Employer/Affirmative Action Employer
Title
The State of Florida does not tolerate violence in the workplace.
• Available on the Internet at:
WHERE TO FIND
Position Number _______________________________ Date Available _____________________
?
• Job and Benefits Center
VACANCY
Consult your local phone directory
Counties of Interest: ________________________________________________________________
INFORMATION
• State agency personnel offices
Minimum Acceptable Salary: _________________________________________________________
G E N E R A L
I N S T R U C T I O N S
H O W
D O
W E
C O N T A C T
Y O U
• Please type or print in ink.
• To be considered for employment, complete your application in its
entirety, sign in the certification section and specify the position for
which you are applying.
Your Name
• Your application must be received by the office announcing the
vacancy by the closing date.
• A separate application must be submitted for each vacancy.
• Photocopies are acceptable.
• All information you submit is subject to verification.
• The State of Florida hires only U.S. citizens and lawfully authorized
alien workers.
• If you require special disability accommodations, notify the agency’s
hiring authority in advance.
• If claiming Veterans’ Preference, complete the Veterans’
City
County
State
Zip Code
Preference Section.
• All males between the ages of 18 and 26 must be registered with
the Selective Service System or exempted.
Home Phone
Business Phone
EDUCATION
HIGH SCHOOL:
NAME/ADDRESS OF SCHOOL
RECEIVED:
Diploma
Other (specify)
None
YOUR NAME, IF DIFFERENT WHILE ATTENDING SCHOOL:
COLLEGE, UNIVERSITY OR PROFESSIONAL SCHOOL:
(TRANSCRIPTS MAY BE REQUIRED)
DATES OF
CREDIT
MAJOR/MINOR
TYPE OF
ATTENDANCE
HOURS
COURSE OF
DEGREE
NAME OF SCHOOL
LOCATION
(MONTH/YEAR)
EARNED
STUDY
EARNED
FROM
TO
QTR
SEM
YOUR NAME, IF DIFFERENT WHILE ATTENDING SCHOOL:
JOB-RELATED TRAINING OR COURSE WORK:
(VOCATIONAL, TRADE, GOVERNMENTAL, BUSINESS, ARMED FORCES, ETC.)
DATES OF
CREDIT
TRAINING
ATTENDANCE
HOURS
COURSE OF
COMPLETED?
NAME OF SCHOOL
LOCATION
(MONTH/YEAR)
EARNED
STUDY
FROM
TO
CLASS
CLOCK
YES
NO
YOUR NAME, IF DIFFERENT WHILE ATTENDING SCHOOL:
LICENSURE, REGISTRATION, CERTIFICATION
EXAMPLES:
Driver License, Teacher Certification, RN, LPN, PE, CPA, Etc.
LICENSE, REGISTRATION OR CERTIFICATION:
Number
Date Received
Expiration Date
State Licensing Agency
1
1
2
3
4
