Optional Application For Federal Employment Form - U.s. Office Of Personnel Management Page 4

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Section D - Education

Upon request from the employing Federal agency, you must provide documention or proof that your degree(s) is from a school accredited by an accrediting body recognized by the Secretary,

U.S. Department of Education, or that your education meets the other provisions outlined in the OPM Operating Manual. It will be your responsibility to secure the documentation that verifies that

you attended and earned your degree(s) from this accredited institution(s) (e.g. official transcript). Federal agencies will verify your documentation.

For a list of postsecondary education institutions and program accredited by accrediting agencies and state approval agencies recognized by the U.S. Secretary of Education, refer to the U.S.

Department of Education Office of Postsecondary Education website at

For information on Educational and Training Provisions or Requirements, refer to the OPM Operating Manual available at

Do not list degrees received based solely on life experience or obtained from schools with little or no academic standards.

1. Last High School (HS)/GED School. Give the school's name, city, state, ZIP Code (if known), and year diploma or GED received:

Some HS

HS/GED

Associate

Bachelor

Master

Doctoral

2. Mark highest level completed:

Total Credits Earned

3. Colleges and universities attended.

Degree (if any),

Major(s)

Do not attach a copy of your transcript unless requested

Year Received

Semester

Quarter

3a. Name

City

State

Zip Code

3b. Name

City

State

Zip Code

3c. Name

City

State

Zip Code

Section E - Other Education Completed

Do not list degrees received based solely on life experience or obtained from schools with little or no academic standards.

Section F - Other Qualifications

License or Certificate

Date of Latest License or Certificate

State or Other Licensing Agency

Section G - Other Qualifications

Job-related training courses (give title and year). Job-related skills (other languages, computer software/hardware, tools, machinery, typing speed, etc.).

Job-related honors, awards, and special accomplishments (publications, memberships in professional/honor societies, leadership activities,

public speaking, and performance awards). Give dates, but do not send documents unless requested.

Section H - General

Yes

1a. Are you a U.S. citizen?

1b. If no, give the Country of your citizenship.

2a. Do you claim veterans' preference?

Yes

If yes, mark your claim of 5 or 10 points below.

Attach your Report of Separation from Active Duty (DD 214) or other proof.

2b. 5 points

Attach an Application for 10-Point Veterans' Preference (SF 15) and proof required.

2c. 10 points

3. Check this box if you are an adult male born on or after January 1st 1960, and you registered for Selective Service between the ages of 18

through 25

4. Were you ever a Federal civilian employee?

Yes

If yes, list highest civilian grade for the following:

4c. From (mm/yyyy)

4d. To (mm/yyyy)

4a. Series

4b. Grade

5a. Are you eligible for reinstatement based on career or career-conditional Federal status?

Yes

If requested in the vacancy announcement, attach Notification of Personnel Action (SF 50), as proof.

5b. Are you eligible under the ICTAP*?

Yes

*ICTAP (Interagency Career Transition Assistance Plan):A participant in this plan is a current or former federal employee displaced from a Federal agency. To be eligible,

you must have received a formal notice of separation such as a RIF separation notice. If you are an ICTAP eligible, normally you will be provided priority consideration for

vacancies within your commuting area for which you apply and are well qualified.

Section I - Applicant Certification

I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete, and made in good

faith. I understand that false or fraudulent information on or attached to this application may be grounds for not hiring me or for firing me after I begin work,

and may be punishable by fine or imprisonment. I understand that any information I give may be investigated.

1b.. Date (mm/dd/yyyy)

1a. Signature

U.S. Office of Personnel Management

NSN 7540-01-351-9178

OF 612

Previous edition usable

50612-101

Revised June 2006

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