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Navigating the job application process in Virginia can feel overwhelming, but understanding the intricacies of the Virginia Job Application Form (DHRM Form 10-012, Rev. 9/03) is a good starting point. This form serves as the primary document for all individuals aspiring to become part of the Commonwealth of Virginia's workforce. It is meticulously designed to ensure an equitable and comprehensive evaluation process, emphasizing the state's commitment to equal opportunity employment. Prospective applicants are advised to fill out the form with utmost care, providing information ranging from personal details and educational background to employment history and references. The form also includes sections for indicating the type of employment the applicant is seeking, their availability, and a certification section that underscores the importance of honesty in the application process. Additional provisions are made for individuals with disabilities, offering assistance in completing the application, thus reflecting the inclusive ethos of the Commonwealth's employment practices. Moreover, the form has provisions for those with military backgrounds, underlining the state's appreciation for veterans and their service. With its comprehensive approach to gathering applicant information, the Virginia Job Application Form is a key tool in the Commonwealth's efforts to assemble a capable and diverse workforce.

Virginia Job Application Example

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

1

2

3

4

5

 

6

7

 

 

 

Name and Location of Institution

 

 

Hrs

 

Degree

 

 

Major or Specialty

Minor

Dates Attended

 

 

 

 

 

 

Received

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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?

Yes

No

a.

Job Title

 

 

 

 

 

 

 

 

 

 

Duties:

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

b.

Job Title

 

 

 

 

 

 

 

 

 

 

Duties:

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

Immediate supervisor

Title

 

 

 

 

 

 

 

Salary (start)

 

 

(finish)

 

Dates (mo/yr)

 

 

to (mo/yr)

Full-time

 

Part-time

Hours/week

 

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

c. Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Duties:

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

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

Address

Phone

Relationship

 

 

 

 

 

 

 

 

 

 

 

 

12.MISCELLANEOUS

a.

Check which shift you will accept:

Day

Evening

Night

Rotating

Weekends

Specify shift hours

b.

Check which job status you will accept:

Full-time

 

Part-time (specify)

 

 

 

 

c.

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?

Yes

No.

 

 

g.

For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States?

 

Yes

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

Name

 

 

 

Announcement Number

 

 

 

Job Title

Duties:

Employer

Address

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Type of business

Immediate supervisor

Title

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

Hours/week

 

Job Title

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Type of business

Immediate supervisor

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

 

Part-time

 

 

 

 

Hours/week

 

 

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

DHRM Form 10-012A(Rev 9/03)

 

Attachment Number

 

 

 

Supplementary Experience Form

Social Security Number

 

Position Applied For

Name

 

 

 

Announcement Number

 

 

 

Job Title

Duties:

Employer

Address

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Type of business

Immediate supervisor

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Type of business

Immediate supervisor

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

 

Part-time

 

 

 

 

Hours/week

 

 

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Job Title

Employer

Address

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

Part-time

 

 

 

 

Hours/week

 

 

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

Type of business

 

 

 

 

 

 

 

 

 

Immediate supervisor

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary (start)

 

 

 

 

 

 

(finish)

 

Dates (mo/yr)

 

 

 

 

 

 

to (mo/yr)

Full-time

 

 

Part-time

 

 

 

 

Hours/week

 

 

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Duties:

Number and titles of employees you supervised Equipment used

Reason for leaving

Your name if different from present

Download Virginia Job Application File

Form Properties

Fact Detail
Form Name and Revision DHRM Form 10-012 (Rev. 9/03)
Form Issued By Commonwealth of Virginia
Equal Opportunity Statement The form states that employees and applicants will be given equal opportunity without regard to race, color, religion, political affiliation, national origin, disability, marital status, gender, or age.
Accommodation for Disabilities Provides a means of confidential assistance for individuals with disabilities who are unable to complete the form without help.
Selection for Honorable Discharge Veterans Asks if the applicant is a veteran with an honorable discharge who has either served more than 180 consecutive days or has a service-connected disability, indicating compliance with Section 2.2-2903 of the Code of Virginia.
Legal Work Eligibility Requires an affirmation of legal eligibility for employment in the United States in compliance with The Immigration Reform and Control Act of 1986.

Steps to Filling Out Virginia Job Application

Filling out the Virginia Job Application form thoroughly and accurately is crucial for job seekers looking to secure employment within the Commonwealth's various agencies. The form is designed to give potential employers a comprehensive overview of an applicant's qualifications, including education, work experience, and other relevant skills or certifications. Following each step carefully ensures that the application reflects the applicant's abilities and experience accurately.

  1. For the position applied for, enter the title of the job you are applying for.
  2. In the agency field, write the name of the agency that announced the vacancy.
  3. Social Security No. is optional; however, remember it might be required on other employment forms.
  4. Under Full legal name, provide your last name, first name, and middle initial where indicated.
  5. For address, enter your home address including city, state, and zip code.
  6. Add your home phone and business phone numbers, along with your e-mail address.
  7. In the EDUCATION section, mark your highest grade completed and provide details of your educational background, including any degrees earned, the institution attended, and the major or specialty studied.
  8. In the EXPERIENCE section, describe all relevant paid, military, and voluntary experience. Start with your most recent job, highlighting the roles and responsibilities that best showcase your qualifications for the position you are applying for.
  9. Answer all miscellaneous questions regarding employment preferences, eligibility, and background information accurately.
  10. In the REFERENCES section, list three people who are not related to you but can vouch for your qualifications and work ethic.
  11. Indicate when you would be available to start work.
  12. Read the certification carefully, then sign and date the application to verify that all the information provided is truthful and complete.
  13. If applicable, fill out and attach the Supplementary Experience Form(s) to provide additional information on your previous employment.

After completing the form, review it to ensure all information is accurate and that no sections have been inadvertently skipped. This detailed approach to filling out the application can improve the chances of moving forward in the recruitment process. The form, when filled correctly, becomes a tool to showcase your strengths and abilities to potential employers within the Commonwealth of Virginia.

FAQ

What is the Virginia Job Application form?

The Virginia Job Application form, also known as DHRM Form 10-012, is a document used in the state of Virginia for job seekers to apply for employment within state agencies. It collects comprehensive information about the applicant's education, work experience, and personal details to evaluate their suitability for the job they are applying for.

Is providing a Social Security number mandatory on this application?

No, providing your Social Security number on the Virginia Job Application form is optional. Failure to include it will not prevent your application from being considered for employment. However, it may be required on other forms related to employment at a later stage.

How should I submit my Virginia Job Application?

You should send your completed Virginia Job Application directly to the agency that announced the job vacancy. Ensure that the form is printed in ink (preferably black) or typed.

What if I need assistance filling out the application due to a disability?

If you have a specific disability that prevents you from completing the application on your own, you can obtain confidential assistance by calling the agency to which you are applying.

Can I list voluntary experience on this application?

Yes, the Virginia Job Application form allows you to describe all paid, military, and applicable voluntary experience. Highlighting your knowledge, skills, and abilities that demonstrate your qualifications for the position is encouraged.

What should I do if I need more space for my work experience?

Use Supplementary Experience Form(s), identified as DHRM Form 10-012A, if you require additional space to detail your employment history. These forms allow for a continuation of the experience section from the main application.

Who should I list as references on the application?

List the names, addresses, and relationships of three individuals not related to you who are familiar with your qualifications. Make sure these references can provide insights into your abilities and work ethic.

What types of job statuses am I able to apply for?

The application provides options to indicate your willingness to accept full-time, part-time, salaried or hourly positions, including those that only offer leave benefits for part-time work.

Am I required to disclose any convictions?

Yes, you are required to disclose any law violations, including moving traffic violations. However, details such as the date of charge, date of conviction, and the county, city, or state of the conviction must be included. Virginia juvenile adjudications for specific serious crimes must also be disclosed if you were aged between 14 and 18 when charged.

What is the process after submitting the application?

After submitting your application, it will go through a review process to ensure you meet the qualifications for the position. You may be contacted for an interview or further assessment. Note that all information provided in the application is subject to verification, and you consent to background checks and reference checks by signing the application.

Common mistakes

When filling out the Virginia Job Application form, applicants tend to make a number of mistakes, which can impact their chances of securing a job. Here are eight common errors to avoid:

  1. Misunderstanding the instructions for how to complete the form, either by not printing in ink or typing, which can lead to processing delays.
  2. Not specifying the position number for the job they're applying for, making it difficult for employers to match the application to the correct job vacancy.
  3. Omitting their Social Security Number (SSN) when it's stated that it's optional but could be necessary for further documentation if employed.
  4. Failing to detail their complete education history, including the highest grade completed, any degrees earned, and relevant dates, which can demonstrate qualification levels.
  5. Not using supplementary forms for additional space when listing extensive experience, which can lead to incomplete job histories being presented.
  6. Skipping the section on licences, certificates, or authorizations to practice a profession, which are critical qualifications for certain positions.
  7. Providing references without specifying their relationship or contact information, which makes it impossible for employers to follow up on the applicant's qualifications.
  8. Incorrectly answering questions about legal eligibility for employment, which is critical information that affects employment possibilities.

To increase their chances of being considered for employment, applicants should thoroughly review their applications for these common errors before submitting them. Each section of the form plays a vital role in the employment process, and accuracy and completeness cannot be overstated.

Documents used along the form

When embarking on a job application journey in Virginia, it's essential to be well-prepared with all the necessary forms and documents that might be needed alongside the Virginia Job Application form. These documents play a critical role in presenting a comprehensive view of your qualifications, work history, and personal background to potential employers. Let's delve into some of these crucial documents:

  • Resume/CV: Offers a detailed overview of your educational background, work experience, skills, and accomplishments. Tailor your resume to highlight the most relevant information for the position you're applying for.
  • Cover Letter: Provides a personalized introduction and explains your interest in the position and the company. It's your chance to make a strong first impression and connect your skills directly to the job description.
  • References List: A curated list of professional references, including former supervisors or colleagues, who can vouch for your qualifications and work ethic. Make sure to ask permission before listing anyone as a reference.
  • Educational Transcripts: May be required to verify your academic achievements, especially if the job requires specific educational qualifications.
  • Certification and License Documents: Essential for positions that require professional certifications or licenses (e.g., teaching, nursing, commercial driving). These documents prove your qualifications and legal eligibility to perform job-specific duties.
  • Background Check Authorization Form: Some employers will ask for your consent to perform a background check. This form authorizes the employer to check your criminal record, educational background, and previous employment.
  • Drug Test Consent Form: This form is required if the job offer is contingent upon passing a drug test. Signing this form indicates your consent to undergo drug testing as part of the pre-employment screening process.

Remember, each of these documents serves its unique purpose in the job application process, providing a holistic picture of who you are as a professional. Ensuring that you have these documents prepared and tailored for the role you're applying to can significantly enhance your chances of securing employment. It's not just about filling out an application form; it's about presenting a complete package that showcases your best self to potential employers.

Similar forms

The Virginia Job Application form is similar to several other standard forms used in the hiring process, including the Federal Employment Application and generic job application templates found across various industries. These documents serve the fundamental purpose of collecting applicant information in a structured format, allowing employers to efficiently evaluate candidates' qualifications, experience, and suitability for a position.

The Federal Employment Application (OF-612), for instance, shares a common framework with the Virginia Job Application form. Both solicit detailed personal information, educational background, work history, and references. They require the applicant to certify the accuracy of the information provided, with a clear statement regarding the implications of falsification. Where they align most closely is in their comprehensive approach to employment history, asking for specifics about duties, employment dates, supervisor names, and reasons for leaving past positions. This thoroughness ensures a well-rounded view of an applicant's professional journey.

Similarly, generic job application templates used by many private sector employers mirror the structure of the Virginia Job Application form. These templates often request personal data, contact information, education, and detailed employment history. Like the Virginia form, they might include questions about certifications, licenses, and special skills pertinent to the job role. Moreover, sections inquiring about the applicant's ability to meet work schedule requirements, travel for work, and eligibility to work in the United States are also common. Through these similarities, it's evident that the Virginia Job Application form embodies a universal format designed to capture a candidate's comprehensive professional profile, thereby facilitating a streamlined hiring process.

Dos and Don'ts

When filling out the Virginia Job Application form, there are several things you should keep in mind to ensure your application is complete, accurate, and presents you in the best possible light. Here is a list of dos and don'ts to guide you through this process:

  • Do print in ink or use a typewriter as instructed by the form to ensure that your application is legible and professional.
  • Don't overlook the option to call for assistance if you have disabilities that make filling out the application challenging. The Commonwealth of Virginia provides confidential assistance to accommodate your needs.
  • Do carefully read and follow all instructions on the application, especially regarding optional fields such as your Social Security Number, to ensure you're providing all necessary information without compromising your personal security.
  • Don't leave blank spaces for fields that are relevant to you. If a question does not apply, it's better to indicate with "N/A" (not applicable) rather than leaving it blank, which might suggest an oversight.
  • Do provide detailed information about your education and experience, including any volunteer work or skills that make you a strong candidate for the position.
  • Don't include references, former employers, or educational institutions that you have not informed or that might not provide a positive verification of your qualifications.
  • Do give accurate and truthful responses throughout the application. Misrepresentation or falsification of information can lead to disqualification or termination of employment.
  • Don't forget to sign and date the application form. An unsigned application may not be processed, delaying or invalidating your candidacy.

Each component of the Virginia Job Application form is designed to give you the opportunity to present your qualifications comprehensively. Paying close attention to these dos and don'ts will help you complete the form accurately and effectively, thus enhancing your chances of securing employment with the Commonwealth of Virginia.

Misconceptions

When it comes to applying for a job in Virginia, there are several common misunderstandings that applicants may have about the process. These misconceptions can make the application process seem more daunting than it actually is. Here's a look at some of these myths and the truths behind them:

  • Misunderstanding #1: You must submit your Social Security Number (SSN) on the application for it to be considered.

    Truth: While the form indicates a place for your SSN, it clearly states that failing to provide it will not bar you from employment consideration. Your SSN may be requested later for other purposes.

  • Misunderstanding #2: You can only apply for one job at a time with a single application.

    Truth: Applicants must specify the agency and position they are applying for, suggesting a need for separate applications for different positions or agencies to ensure proper consideration.

  • Misunderstanding #3: The application doesn't need to detail volunteer experience because only paid experiences are valuable.

    Truth: The application form explicitly asks for all applicable experience, including volunteer work, as this can highlight skills and responsibilities relevant to the position applied for.

  • Misunderstanding #4: Educational achievements that aren't complete aren't worth mentioning.

    Truth: The form encourages applicants to include information about expected completion dates of educational programs, indicating that ongoing education is valued and considered.

  • Misunderstanding #5: You don't need to indicate a willingness to travel if the job description doesn't mention it.

    Truth: The form asks about travel willingness, suggesting that job roles can evolve or include responsibilities not explicitly mentioned in the job description, and being upfront about your travel capabilities is important.

  • Misunderstanding #6: Providing information on legal US work eligibility is optional.

    Truth: Confirming your legal eligibility to work in the US is a mandatory step in the employment process, as indicated by the requirement to fill out a certification upon employment.

  • Misunderstanding #7: The Commonwealth of Virginia employs on a first-come, first-served basis.

    Truth: The Commonwealth is an Equal Opportunity Employer, extending equal employment opportunities to all individuals based on their qualifications and abilities to perform the duties of the job, without regard to race, color, religion, political affiliation, national origin, disability, marital status, gender, or age.

  • Misunderstanding #8: You should wait until contacted for an interview to provide references.

    Truth: The application form asks for a list of three references who are not related to you but can attest to your qualifications, indicating that references are an initial part of the application process, not a later addition.

Understanding the specifics of the Virginia Job Application form and clarifying these misconceptions can help applicants submit more complete and accurate applications, improving their chances of securing employment with the Commonwealth of Virginia.

Key takeaways

When completing the Virginia Job Application form, it is essential to consider several key points to ensure the application is filled out correctly and presents the applicant in the best possible light. Here are six key takeaways:

  • Applications must be completed using ink, preferably black, or a typewriter. This requirement ensures clarity and legibility, which aids in the accurate processing of the application.
  • The form is an equal opportunity employer document, meaning all applicants are considered for employment without discrimination based on race, color, religion, political affiliation, national origin, disability, marital status, gender, age, or any other protected class.
  • Disclosure of the applicant's Social Security Number (SSN) is optional at the application stage. However, it may be required for employment purposes later. This approach balances privacy concerns with the necessity of SSN for administrative purposes once employment is offered.
  • The education section not only queries about the highest grade completed and any post-high school education but also provides an opportunity to highlight future educational achievements. This feature allows candidates to showcase their commitment to ongoing professional development.
  • Experience is a critical section, requiring detailed information about past employment, including job titles, duties, employers' details, and reasons for leaving. This comprehensive history offers employers a snapshot of the applicant's professional background and the trajectory of their career.
  • The application features sections for additional information, such as automated word processing skills, licenses, certificates, and references, to provide a complete picture of the applicant's qualifications and readiness for the position.

Adhering to these guidelines not only ensures compliance with the application's requirements but also improves the chances of the application making a positive impression on potential employers in the Commonwealth of Virginia.

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