Form Ds-174 - Application For Employment As A Locally Employed Staff Or Family Member - U.s. Department Of State Page 2

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15. What days are you available to work as part of a regularly scheduled work week? (Check all that apply.)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

16. Do any of your relatives or members of your household work for the United States Government?

Yes

If yes, provide the details below. If you need more space, use an additional sheet of paper. (See Instructions for Completing the DS-174 for the

definition of relatives and members of household.)

Name

Relationship

Agency, Position, and Location

U.S. CITIZEN ELIGIBLE FAMILY MEMBER (USEFM) AND U.S. VETERANS HIRING PREFERENCE

17. Are you claiming preference in hiring under U.S. law and policy based upon your status as either a U.S. Citizen Eligible Family Member (USEFM)

or U. S. Veteran? See Instructions for Completing the DS-174 for additional information about the USEFM and U.S. Veterans hiring preference.

(Check only one.)

U.S. Citizen EFM.

U.S. Veteran.

U.S. Citizen EFM and also a U.S. Veteran.

Neither a U.S. Citizen EFM, nor a U.S. Veteran.

Have you invoked this preference for a prior position at this post/Mission?

Yes

If yes, which agency?

Date (mm-dd-yyyyy)

If claiming eligibility for U.S. Veteran preference, you must attach a copy of your most recent DD-214, Certificate of Release or Discharge from Active

Duty. If claiming conditional eligibility for U.S. Veterans preference, you must submit proof of conditional eligibility.

EDUCATION

18. Graduate School

Dates Attended

Did you

Degree/Diploma

Major Subject

Name of School, City, State or Country

(mm-yyyy)

graduate?

From

Yes