Employment Application - City Of Newport (Page 4 of 9) in pdf

City of Newport

Veteran’s Preference Form

Under Oregon law, Veterans who meet minimum qualifications for a position may be eligible for employment

preference. If you think you qualify, please read the following checklist carefully. Check the box for each item that is

appropriate. If you need further explanation or have special circumstances please contact Human Resources at 541-

574-0604.

This completed form and the required documentation must be submitted to The City of Newport Human

Resources Department at the time you submit your application.

A. Qualified Veteran Questions: You may claim Veteran’s Preference if you check at least one box in any of the

four sections below and provide proof of eligibility by submitting a copy of your DD-214 or DD-215, Certificate of

Release and Honorable Discharge.

ORS 408.225 (d)

□ I served on active duty with the Armed Forces of the United States for a period of more than 178 consecutive days and was discharged

or released under honorable conditions; or

□ I served on active duty with the Armed Forces of the United States for a period of more than 178 consecutive days and was discharged

or released under honorable conditions because of a service-connected disability; or

□ I served on active duty with the Armed Forces of the United States for at least one day in a combat zone and was discharged or

released from active duty under honorable conditions; or

a combat or campaign ribbon for service in the Armed Forces of the United States.

□ I received

“Active Duty” does not include attendance at a school under military orders, except schooling incident to an active

enlistment or a regular tour of duty, or normal military training as a reserve officer or member of an organized reserve

or a National Guard unit.

B. Qualified Disabled Veteran Questions: You may claim additional employment preference if you can check at

least one box in any of the three sections below and provide proof of eligibility by submitting both of the documents

listed below:

1. A copy of your DD-214 or 215, Certificate of Release and Honorable Discharge, Copy 4, and

2. A public employment preference from the United States Department of Veterans’ Affairs. To order the letter call 1-800-827-1000

and request a public employment preference letter.

ORS 408.225 (b)

□ I am entitled to disability compensation under laws administered by the United States Department of Veterans’ Affairs; or

□ I was discharged or released from active duty for a disability incurred or aggravated in the line of duty; or

□ I was awarded the Purple Heart for wounds received in combat.

I hereby claim Veteran’s Preference points and certify that the above information is true and correct. I understand that

any false statements may be cause for my disqualification or dismissal, regardless of when discovered.

Print Name

Social Security Number

Signature of Applicant

Date

Position Applied for:

ORS 408.225-230

Preference will not be awarded without the appropriate documentation. You must submit your DD-214 or 215 in all cases. If you are claiming Disabled

Veteran points, you must also submit the public employment preference letter from the Department of Veterans’ Affairs. You will not receive

preference without these accompanying documents.

**Preference points are allocated as follows 5 points or .05% for Veteran’s Preference and 10 points or .10% for Disabled Veteran’s Preference where

number system or points are used to hire candidates. Points are applied at each step of the process that would result in a disqualification.

Employment Application - City Of Newport Page 4

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