Form Msd 330 - Civil Service Application Form Page 2
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311.SERVICE IN ARMED FORCES
YES NO
12. VETERANS’ CREDITS
Do you draw additional credits on the exam as an
A. Have you ever served in the armed forces of the U.S.?
honorably discharged veteran?
CHECK ONE
B. If “YES,” have you ever received a discharge from such
YES, as disabled war veteran
YES, as a non-disabled war veteran
forces which was other than honorable?
YES, as a disabled war veteran who previously
If answer is “YES” give full particulars on additional sheet.
used non- disabled war veteran credits
MONTH | DAY | YEAR
NO
C. Date of entry into active service
If “YES” please request and fill out separate form for
D. Date of discharge
veteran’s credits
E. Service serial number
13. LICENSES: If a license, certificate or other authorization to practice a trade or profession is listed as a requirement on the announcement
of the examination(s) for which you are applying, complete the following question: If not currently licensed check this box
Name of Trade or Profession
License Number
Granted by (Licensing Agency)
City or State of
Specialty
Date License First Issued
Registered from:
To
14. EDUCATION: If credit is claimed for a partially completed college curriculum or correspondence course, attach a list of courses and credit or semester
hours completed. Indicate how many credit hours or courses are required for graduation. Do Not send transcript unless required by announcement.
No
If YES, Name and Location of High School
Have you graduated from high school? Yes
If you have a high school equivalency diploma, indicate Issuing Governmental Authority
Number
Date of Issue
Attendance
Type
No. of
Day
Full or
No. of
Did you
Type of
Name of School and
Dates (Month &
Course or
College
Or
Part
Years
graduate
Degree
City in which located
Year)
Major
Credits
Night
Time
Credited
Yes or No
Received
From
To
Subject
Received
College
University
Professional or
Technical School
Other Schools or
Special Courses
15. EXPERIENCE: Describe under the headings given below any employment or occupation you have ever had which includes experience that tends to
qualify you for the position sought, and as far as possible, every other employment, including war service. Begin with your most recent employment and
work backward consecutively to your first one.
You may attach a resume. However, attachment of a resume does not satisfy this requirement. Employment used to
Applicants may be required to furnish satisfactory proof of experience claimed.
qualify an applicant for a position/examination must be listed on this application.
Attach additional sheets if needed.
LENGTH OF EMPLOYMENT
Firm Name
Address
City and State
From: Mo
Yr.
Type of Business
Your Title
Name and Title of Immediate Supervisor
To:
Mo
Yr.
DUTIES: Describe the nature of the work personally performed by you, with estimated percentage of time on each type
of work. State size and kind of working force, if any supervised by you and extent of such supervision
Total
Yrs
Mos
MONTHLY SALARY
Min.
Max
Last
Total hrs per WEEK
hrs
Reason For Leaving
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