Fillable Veteran'S Preference Form printable pdf download

Veteran’s Preference Form

Under Oregon law, veterans who meet the minimum qualifications for a position may be eligible for employment preference.

If you think you qualify, please read this document carefully. Check each box that applies to you. If you need further

explanation or have special circumstances, call Sean O'Day at 503-540-1601.

This completed form and the required documentation must be submitted at the time you submit your employment

application. Information submitted on or with this form will be used solely to determine your veteran’s preference.

Part 1: Qualified Veteran

You may claim veteran’s preference if you are able to check at least one of the following seven boxes and provide proof of

eligibility by submitting a copy of your DD-214 or 215 (and Certification of Honorable Discharge if the DD-214 or 215 does not

specifically indicate the type of discharge) or a letter from the United States Department of Veterans Affairs indicating you

receive a nonservice-connected pension. “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.

ORS 408.225(1)(e)

 I served on active duty with the Armed Forces of the United States for a period of more than 90 consecutive days

beginning on or before January 31, 1955 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

beginning after January 31, 1955 and was discharged or released from active duty under honorable conditions; or

 I served on active duty with the Armed Forces of the United States for 178 days or less and was discharged or released

from active duty under honorable conditions because of a service-connected disability; or

 I served on active duty with the Armed Forces of the United States for 178 days or less and was discharged or released

from active duty under honorable conditions and have a disability rating from the United States Department of Veterans

Affairs; 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

 I received a combat or campaign ribbon or an expeditionary medal for service in the Armed Forces of the United States

and was discharged or released from active duty under honorable conditions; or

 I am receiving a nonservice-connected pension from the United States Department of Veterans Affairs.

Part 2: Qualified Disabled Veteran

You may claim additional veteran’s preference if you can check any of the following three boxes and provide proof of eligibility

by submitting a copy of your DD-214 or 215 (and Certificate of Honorable Discharge if the DD-214 or 215 does not specifically

indicate the type of discharge) and a public employment preference letter from the United States Department of Veterans

Affairs or other verifiable documentation certifying disabled veteran status.

ORS 408.225(1)(c)

 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 claim veteran’s preference 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

Position Applied For

Signature

Date

Preference will not be awarded without proper documentation. Late or incomplete submittals will not be considered.

Qualified veterans receive 5 preference points and qualified disabled veterans receive 10 preference points, applied at each

step of the application process that would result in a disqualification.

Veteran'S Preference Form

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