Va Form 4637 - Employee Educational Data

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EMPLOYEE EDUCATIONAL DATA
PRIVACY ACT STATEMENT: The authority for collecting this information about you is 5 U.S.C. 7201. The information furnished will be used to
update your education level to reflect the highest level achieved. The information you furnish is voluntary and will be used for workforce analysis
and planning. Executive Order 9397 (November 22, 1943) authorizes use of your Social Security Number. That Order requires use of the SSN for the
orderly administration of personnel records. Furnishing your Social Security Number as well as the other data is voluntary. Disclosure of this
information may be made in accordance with the disclosure provisions of the Privacy Act of 1974 including the established routine uses for the
OPM/GOVT-1, General Personnel Records system of records, or the 76VA05 system for Title 38 employees.
INSTRUCTIONS - Please complete this form according to the instructions and if you have any questions, contact your Human Resources (HR) office. Return
completed form to your HR office. (Note: In order to keep your education record up-to-date, be sure to notify the HR office whenever you attain a higher level of
education than the level you show on this form.)
PART I - EDUCATION CODES
INSTRUCTION: Check the one box next to the code in Section A or B that best represents your highest education level. Then follow instructions in that section.
SECTION A - GENERAL EDUCATION LEVELS
C - One academic year of study (30-59 semester hours, 45-89
1- Less than 8th grade or no formal education
quarter hours) in a resident college or university.
2 - 8th grade
D - Two academic years of study (60-89 semester hours, 90-134
A - Some high school -- did not graduate
quarter hours) in a resident college or university.
B - High school graduation or equivalency certificate, and no
7 - Four academic years of study (120 semester hours, 180 quarter
completion of any advanced job training.
hours, or more) but did not receive a bachelor's degree.
3 - High school graduation and afterwards began additional job
L - Bar membership without law degree.
training program without completing.
5 - Less than one academic year of study (under 30 semester hours/
E - Three academic years of study (90-119 semester hours, 135-179
45 quarter hours) in a college or university.
quarter hours) in a resident college or university.
If you checked one of the boxes above go to PART II, otherwise continue in Section B.
SECTION B - HIGHER EDUCATION CERTIFICATE OR DEGREE
4 - Completed high school and afterwards completed additional
O - Master's degree in Hospital Administration
job training program.
# - Master's degree in Nursing
6 - Associate degree (including nursing and all other associate
P - All other master degrees
degrees.)
Q - Some academic work beyond master's degree but
F - Nursing diploma
no higher degree
G - Bachelor's degree in Nursing
R - Doctor of Dental Medicine
S - Doctor of Dental Surgery
H - Bachelor's degree in Engineering or Architecture
T - Doctor of Medicine
I - Bachelor's degree in Accounting or Finance
U - Doctor of Osteopathy
J - Bachelor's degree, all other fields
V - Doctor of Veterinary Medicine
8 - Bachelor's degree and less than 15 semester hours, 23 quarter
9 - All other professional degrees (including podiatry, D.P. or
hours of graduate study
D.P.M., and optometry, O.D.)
N - One academic year of graduate study (15 semester hours,
* - Doctoral degree in Nursing
23 quarter hours) but no master's degree
W - Doctor of Philosophy
K - Law degree (J.D. or LL.B.) without bar membership
X - Ph.D. in Psychology
L - Bar membership with law degree
Y- Other doctoral degrees
M- Law degree (J.D. or LL.B) with bar membership
Z - Doctoral degree and performed some academic work beyond
If you checked one of the boxes in Section B, then more specific information is needed. Please review the supplemental (which is either attached or
may be provided later by your HR office) and select the most appropriate field of study from the programs listed and record the corresponding 6-digit
program code in Part II.
PART II - EMPLOYEE INFORMATION
1. WHAT IS YOUR ONE DIGIT EDUCATION CODE
COMPLETE IF YOU SELECTED FROM SECTION B
FROM SECTION A OR SECTION B ABOVE?
2B. ENTER THE SIX DIGIT PROGRAM CODE
2A. WHAT YEAR DID YOU COMPLETE YOUR
HIGHEST LEVEL OF EDUCATION?
EDUCATION CODE
YEAR OF COMPLETION
PROGRAM CODE
(Print or type)
4. SOCIAL SECURITY NO.
3. LAST NAME - FIRST NAME - MIDDLE INITIAL OF EMPLOYEE
5. SERVICE OR DIVISION
6. EMPLOYEE'S SIGNATURE
7. DATE
4637
VA FORM
OCT 2011

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