The Virginia Job Application form is a standardized document used by individuals seeking employment within the Commonwealth of Virginia. This form, known as DHRM Form 10-012, ensures that applicants provide essential information regarding their qualifications, education, and work experience. By completing this application, candidates affirm their eligibility for employment while adhering to the state's commitment to equal opportunity for all individuals.
The Virginia Job Application form, officially known as DHRM Form 10-012, serves as a vital tool for individuals seeking employment within the Commonwealth of Virginia. This form is designed to collect essential information about applicants, ensuring that the hiring process remains fair and equitable. The application requires candidates to provide personal details, including their full legal name, contact information, and the position they are applying for. Additionally, it prompts applicants to outline their educational background and work experience, highlighting their skills and qualifications relevant to the job. Importantly, the form emphasizes the Commonwealth's commitment to equal opportunity employment, prohibiting discrimination based on race, gender, or other personal characteristics. Applicants are also encouraged to seek assistance if they encounter difficulties due to disabilities. Furthermore, the form includes sections for references, preferred work shifts, and various compliance questions related to employment eligibility and veteran status. By completing this application, candidates take a significant step toward securing a position within Virginia's diverse workforce.
Filling out the Virginia Job Application form can be a straightforward process, but many applicants make common mistakes that can affect their chances of securing a position. One prevalent mistake is neglecting to complete all required sections of the application. Each section is designed to gather essential information about the applicant's qualifications and background. Leaving any part blank may raise concerns about the applicant's attention to detail or commitment to the application process.
Another frequent error involves providing inaccurate or outdated contact information. It is crucial to ensure that the home and business phone numbers, as well as the email address, are current. If potential employers cannot reach the applicant, they may move on to other candidates. Additionally, applicants should double-check the spelling of their names and addresses to avoid any discrepancies that could lead to confusion during the hiring process.
Many applicants also fail to highlight their relevant skills and experiences adequately. The application encourages individuals to describe their qualifications clearly. A common oversight is listing job duties without emphasizing how those experiences relate to the position being applied for. Tailoring the information to showcase relevant skills can make a significant difference in how an application is perceived.
Some individuals overlook the importance of the references section. Providing references who are not familiar with the applicant’s qualifications can be detrimental. It is advisable to choose individuals who can speak positively about the applicant’s skills and work ethic. Furthermore, applicants should inform their references in advance that they may be contacted, ensuring that the references are prepared to provide a strong endorsement.
Finally, many applicants do not take the time to review their application before submission. This step is vital to catch any typographical errors or incomplete sections. A well-organized and error-free application reflects professionalism and a serious interest in the position. Taking a few moments to proofread can enhance the overall impression made on potential employers.
DHRM Form 10-012 (Rev. 9/03)
Commonwealth of Virginia
Please print in ink (preferably black) or use typewriter
An Equal Opportunity Employer
Number of attachments
Application for Employment
Position number
Send this application directly to the agency announcing the vacancy.
Employees of the Commonwealth and applicants for employment shall be afforded equal opportunity in all aspects of employment without regard to race, color, religion, political affiliation, national origin, disability, marital status, gender or age.
As a means of accommodation to persons with specific disabilities that prevent them from completing this application, confidential assistance in filling out this application may be obtained by calling the agency to which you are applying.
1.
Position applied for
2. Agency
(one per application)
(Note: Completion of number three is optional. Failure to submit social
3.
Social Security No.
security number on this form will not prohibit employment consideration.
Social security number may be required on other forms prior to employment.)
4.
Full legal name
6.
Home Phone
(
)
Last
First
Middle
5.
Address
7.
Business Phone
( )
8. E-mail Address
City
State
Zip
9.EDUCATION
a.
Check highest grade completed
1
2 3
4 5
6
7
8 9
10
11
12
b.
If you did not complete high school, do you have a high school equivalency diploma?
Yes
No
c.
Check number of years of post high school education
2
3
4
5
Name and Location of Institution
Hrs
Degree
Major or Specialty
Minor
Dates Attended
Received
2.
d. If you expect to complete an educational program in the near future, please indicate what type of degree or program and expected completion date:
10.EXPERIENCE — Use Supplementary Experience Form(s) for additional space. Starting with the most recent, describe ALL paid, military and applicable voluntary experience. Highlight your knowledge, skills and abilities which best demonstrate your qualifications for this position.
You may list significantly different jobs within the same organization as separate items. May we contact your present supervisor?
Job Title
Duties:
Employer
Phone
Type of business
Immediate supervisor
Title
Number and titles of employees you supervised
Salary (start)
(finish)
Equipment used
Dates (mo/yr)
to (mo/yr)
Reason for leaving
Full-time
Part-time
Hours/week
Your name if different from present
Number and titles of employees you supervised Equipment used
c. Job Title
d.Use this space for any additional information you think would help us evaluate your application, including training, seminars, workshops, and special achievements or specialized skills:
e.Automated word processing (specify equipment)
Typing speed
words per minute.
Shorthand speed
words per minute
f. License (to include driver’s), certificate or other authorization to practice a trade or profession.
Type
License Number
Granted by (licensing board)
11.REFERENCES
List names, addresses and relationships of three persons not related to you who know your qualifications:
Name
Relationship
12.MISCELLANEOUS
Check which shift you will accept:
Day
Evening
Night
Rotating
Weekends
Specify shift hours
Check which job status you will accept:
Part-time (specify)
Check which employment status you will accept:
Salaried (benefits)
Hourly (No benefits)
Part-time salaried (leave benefits only)
d.
Are you willing to accept employment which requires you to travel? No
Yes. If yes,
During the day only,
Occasionally overnight,
Frequently overnight.
e.
List the geographic locations in which you are willing to work. If anywhere in Virginia, write “all”
f.
Are you willing to provide your own transportation if necessary for your employment?
No.
g.
For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States?
No. Under the Immigration Reform and Control Act of 1986, you will be required to fill out a certification verifying that you
are eligible to be employed and verifying your identity. Further, you will be required to provide documentation to that effect should you be
employed.
h.Section 2.2-2804 of the Code of Virginia prohibits any board, commission, department, agency, institution or instrumentality of the Commonwealth from employing a person who is required to present himself and submit to the federal Selective Service registration
requirement and failed to do so. If you are/were required to register for the Selective Service, have you done so? Yes No. If no, state reason:
i.For purposes of compliance with Section 2.2-2903 of the Code of Virginia, are you a veteran who received an honorable discharge and has (i) provided more than 180 consecutive days of full-time active- duty in the armed forces of the United States or reserve components thereof, including the National the National Guard, or (ii) has a service-connected disability rating fixed by the United States Veterans Affairs?
Yes No. If yes, did you serve during the Vietnam Conflict (2/28/61-3/7/75)? Yes No
j.Have you ever been convicted* for any violation(s) of law, including moving traffic violations. Yes No If YES, please provide the following:
Description of offense:
Statute or ordinance (if known ): Date of Charge: ; Date of Conviction
County, City, State of Conviction:
(For additional convictions use plain paper. Include all information listed above.)
*Convictions include Virginia juvenile adjudications for Capital Murder, First and Second Degree Murder, Lynching, or Aggravated Malicious Wounding, if you were age fourteen (14) to eighteen (18) when charged.
13.When will you be available to start work? (No date is necessary if you are available as soon as you give two (2) weeks notice.)
Month Day Year
14.CERTIFICATION--Each Application Requires Current Date and Original Signature
I hereby certify that all entries on both sides and attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment in the service of the Commonwealth of Virginia. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent that you may contact references, former employers and educational institutions listed regarding this application. I further authorize the Commonwealth to rely upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be disseminated to other agencies, nongovernmental organizations or systems on a need-to-know basis for good cause shown as determined by the agency head or designee.
Date
Applicant Signature
Pursuant to federal regulations, we collect responses to the questions below for record keeping purposes. This information will NOT be kept with your application for employment. Federal law prohibits unlawful discrimination on the basis of race, color, sex, age, national origin, religion, or disability.
Check the block for the racial or ethnic group with
Check the block for the highest level of education
Check the appropriate block:
which you identify:
you have completed (check only one):
Female
White (includes Arabian)
Less than 8th grade
Male
Black (includes Jamaican, Bahamians and
Completed 8th grade
other Caribbeans of African but not Hispanic
Attended high school
or Arabian descent)
High school graduate or equivalent
Please indicate your date of birth:
/ /
Hispanic (includes persons of Mexican,
Attended college and/or associate degree
Puerto Rican, Central or South American or
College graduate
Position applied for:
other Spanish origin or culture)
Attended graduate school
Position number:
Asian & Asian American (includes Pakistanis,
Master’s degree
Indians & Pacific Islanders)
Graduate study beyond master’s
American Indians (includes Alaskans)
requirements
FOR OFFICE USE ONLY
Ph.D. or professional degree
EEO Category:
How did you find out about this employment opportunity?
Newspaper*
State RECRUIT system
Radio/TV*
Agency Bulletin Board
VEC
Other (please specify)
*specify name of newspaper or other media
DHRM Form 10-012A(Rev. 9/03)
Attachment Number
Supplementary Experience Form
Social Security Number
Position Applied For
Announcement Number
DHRM Form 10-012A(Rev 9/03)
The Virginia Job Application form is similar to the Federal Employment Application form (SF-171). Both documents require applicants to provide personal information, including contact details and work history. They emphasize the importance of equal opportunity employment and often include sections where applicants can detail their education and experience. Additionally, both forms may ask for references and require a signature certifying the accuracy of the provided information.
Another document comparable to the Virginia Job Application form is the Standard Application for Employment used by many private companies. Like the Virginia form, it collects essential information such as the applicant's name, address, and work history. Both forms encourage applicants to highlight their qualifications and skills relevant to the position. They often include sections for additional information, allowing candidates to share unique experiences or certifications that may enhance their application.
The Job Application form used by state agencies in other states also shares similarities with the Virginia form. These applications typically require personal information, educational background, and work experience. They often include questions about the applicant's eligibility for employment and may ask for the same types of supporting documentation. The goal is to ensure a fair assessment of all candidates, similar to the provisions outlined in the Virginia application.
Additionally, the College or University Job Application form mirrors the Virginia Job Application form in its structure and purpose. Both forms seek detailed educational backgrounds, including degrees earned and institutions attended. They also request information about relevant work experience and may include sections for references. Both emphasize the importance of accurate and truthful information, with certifications that the applicant agrees to the terms stated.
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Lastly, the Internship Application form used by various organizations is akin to the Virginia Job Application form. Both require applicants to provide personal details, educational qualifications, and relevant experience. They often include sections for references and may ask specific questions related to the applicant's availability and willingness to accept certain job conditions. The intent is to evaluate candidates fairly and comprehensively, ensuring that all pertinent information is considered during the selection process.
Completing the Virginia Job Application form requires attention to detail and accuracy. This form will help you present your qualifications effectively to potential employers. Follow these steps to ensure you fill out the application correctly.
What is the purpose of the Virginia Job Application form?
The Virginia Job Application form is designed to gather essential information from applicants seeking employment within the Commonwealth of Virginia. It ensures that all candidates provide relevant details about their education, work experience, and qualifications. This standardized form helps agencies evaluate candidates fairly and efficiently, promoting equal opportunity in the hiring process.
How should I fill out the application form?
It is recommended to fill out the application using black ink or a typewriter for clarity. Each section must be completed accurately, including your personal information, education, work experience, and references. If you have a disability that prevents you from completing the application, you can call the agency for assistance. Remember to review your application for completeness before submission.
Do I need to provide my Social Security number?
Providing your Social Security number on the application is optional. However, it may be required on other forms before employment. If you choose not to include it, your application will still be considered for employment. It's important to note that your Social Security number is used for identification and verification purposes.
What if I have gaps in my employment history?
Gaps in employment are not uncommon and can be addressed in your application. When detailing your work experience, you can explain any periods of unemployment in the additional information section. Focus on highlighting your skills and qualifications, and consider including any relevant volunteer work or training during those gaps.
What types of references should I include?
You should list three references who are not related to you and can speak to your qualifications. These could be former supervisors, colleagues, or mentors who are familiar with your work ethic and skills. Make sure to include their names, addresses, phone numbers, and your relationship to them. It’s advisable to inform your references beforehand that they may be contacted.
What happens after I submit my application?
Once you submit your application to the agency, it will be reviewed along with other candidates. If your qualifications match the requirements of the position, you may be contacted for an interview. Be prepared for potential background checks and reference verification, as these are standard procedures in the hiring process.
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