Veterans Preference Form - Douglas County printable pdf download

VETERANS’ PREFERENCE in PUBLIC EMPLOYMENT

If you are seeking VETERANS’ PREFERENCE in employment, please complete this form and return it with your

supporting documentation at the time you submit your completed Douglas County employment application.

Under Oregon law, armed forces veterans who meet minimum qualification standards for an eligible

position may be

entitled to preference in employment or promotion. If you think you may qualify, please read the following information

carefully; check the box(es) in each section that is appropriate to your circumstances. If you need further explanation or

have specific questions, please contact Human Resources at (541) 440-4405.

QUALIFIED VETERAN QUESTIONS:

You may claim veteran’s preference if you are able to check one or more

boxes in this section and provide proof of veteran’s preference eligibility by submitting a copy of your Certificate of

Release or Discharge from Active Duty (a federal DD Form 214 and DD Form 215) at the time you submit your

completed employment application.

ORS 408.225(d) – Veteran

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 from active duty under honorable conditions, or

I served on active duty with the Armed Forces of the United States for a period of 178 consecutive 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 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 for service in the Armed Forces of the United States.

“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.

QUALIFIED DISABLED VETERAN QUESTIONS:

You may claim additional preference as a disabled veteran

if you are able to check one or more boxes in this section and provide proof of eligibility by submitting both (1) a

copy of your Certificate of Release or Discharge from Active Duty (a federal DD Form 214 and DD Form 215) and

(2) a public employment preference letter from the United States Department of Veterans’ Affairs. To order the

employment preference letter, call the VA at 1-800-827-1000 and request a public employment preference letter.

ORS 408.225(b) – Disabled Veteran

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

I was discharged or released from active duty for a disability incurred or aggravated in the line of active 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 or misrepresentations made by me 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-ORS 408.230

Preference will not be awarded without appropriate documentation. You must submit your federal DD Form 214 and/or DD Form 215 in

all cases. If you are claiming disabled veteran preference, in addition to the DD 214/DD 215 you must also submit the public employment

preference letter from the Department of Veterans’ Affairs. You will not receive preference without these documents.

For purposes of complying with ORS 408.230, an “eligible position” means any position for which a hiring or promotion decision is made or required

to be made based on the results of a merit based, competitive process that includes, but is not limited to, consideration of an applicant’s or employee’s

relative ability, knowledge, experience and other skills. (OAR 839-006-0440 (3))

J:\3. SUBJECT FILE INDEX\RECRUITMENT MATERIALS\VET Preference012010a.doc

Veterans Preference Form - Douglas County

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