State Of Oklahoma Employment Application Page 3
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4Name:__________________________
Social Security Number:___________________________
EDUCATIONAL BACKGROUND
Are you a high school graduate or have you passed a general education development (GED) test? Yes_____ No_____
(Will only be used as required by statute, law or bonafide job requirement)
Are you fluent in any language other than English? List all
List colleges, universities or professional schools attended. If more space is needed, attach additional copies of this
page. (Transcripts may be required)
School Name
From
To
Major/Minor or
Hours
Date
Location
Month/Year
Month/Year
Course of Study
Completed
Degree
Completed
List any other job-related training or coursework: (vocational, trade, governmental, business, Armed Forces, etc.)
School Name
From
To
Hours
Date
Location
Month/Year
Month/Year
Course of Study
Completed
Completed
List job-related licensure, registration or certification (teacher certification, nursing licensure, trade licensure, etc.)
License, Registration
Licensing Agency
or Certification
Number
Date Received
Expiration Date
or Board
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Title 21 O.S. Section 358: “It shall be unlawful for any person applying for employment with the State of Oklahoma to make a materially
false, fictitious or fraudulent statement or representation on an employment application, knowing such statement or representation to be
materially false, fictitious or fraudulent. A violation of this subsection shall be punished as provided in subsection B of the Section 359
of this title.”
STATEMENT OF CERTIFICATION By signing this application I certify that the facts contained in this application packet are true and
complete to the best of my knowledge. I understand that if I become employed, falsified statements on this application may be grounds
for dismissal and/or removal from consideration for eligibility for other state employment or employment examinations. I authorize
investigation of all statements and information contained herein. Specifically, I authorize the State of Oklahoma to make all necessary
and appropriate investigations allowable by law to verify the information provided. I understand that if I am hired I will be required to
produce proof that I have a legal right to work in the U.S.A. in accordance with the Immigration Reform and Control Act of 1986.
________________________________________________________________________________________________
Sign Your Name Here
Date
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