Faa Form 54972 - Application For Employment With The Federal Aviation Administration - 2001 Page 3
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12Read each question carefully. Darken the circle for the ONE answer that best describes you. Multiple
or blank responses will result in that question receiving the least credit.
Section 1: APPLICANT INFORMATION
1. I am a citizen of the United States, Guam, American Samoa, U.S. Virgin Islands, or Puerto
0 Yes 0 No
Rico. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2. I am registered with the Selective Service System, or I have a valid exemption from
registration. (NOTE: If you are a female, or were born before December 31, 1959, answer
YES to this question.) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 Yes 0 No
3. I have advocated or knowingly associated with a group advocating the overthrow of the United
0 Yes 0 No
States Government or I have participated in a strike against the United States Government. _
0 Yes 0 No
4. I am currently a permanent civilian employee of the Federal Aviation Administration. _ _ _ _ _
5. I am currently a permanent civilian employee or I have been a permanent civilian employee of
0 Yes 0 No
a Federal agency. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
0 Yes 0 No
6. I am currently a temporary civilian employee of a Federal agency. _ _ _ _ _ _ _ _ _ _ _ _ _ _
0 Yes 0 No
7. I am able to communicate orally and in writing in the English language. _ _ _ _ _ _ _ _ _ _ _ _
0 Yes 0 No
8. I am able to communicate orally and in writing in a language other than English. _ _ _ _ _ _ _
Section 2: MILITARY SERVICE
To claim veterans' preference you are required to submit a copy of your DD-214, Armed Forces of the United
States Report of Transfer or Discharge and if applicable, a SF-15, Application for 10-Point Veteran Preference,
along with required proof.
0 Yes 0 No
1. I have served on active duty in the United States military service. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2. I am claiming 5-point veteran preference based on my active duty military service.
0 Yes 0 No
NOTE: Must submit a copy of your DD-214. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. I am claiming 10-point veteran preference as the spouse, widow, widower or natural mother of
0 Yes 0 No
a disabled or deceased veteran. NOTE: Must submit SF-15 with required proof. _ _ _ _ _ _
4. I am claiming 10-point veteran preference as a Purple Heart recipient or have a service-
0 Yes 0 No
connected disability of less than 10%. NOTE: Must submit SF-15 with required proof. _ _ _
5. I am claiming 10-point veteran preference based on a service-connected disability rated at
0 Yes 0 No
10% or more, but less than 30%. NOTE: Must submit SF-15 with required proof. _ _ _ _ _
6. I am claiming 10-point veteran preference based on a service-connected disability rated at
0 Yes 0 No
30% or more. NOTE: Must submit SF-15 with required proof. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
7. I retired or will be retiring from military service at or above the rank of major (0-4) or its
0 Yes 0 No
equivalent. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
SSN: _______-______-__________
FAA Form 54972 (02/01)
2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business