Employment Application

indicates required field

Title of Open OEIG Position? The OEIG only accepts applications for positions that are currently available within the agency.

Location Office Location

Last Name

First Name

Middle Name

Street Address

City

State

Zip Code

County

Birthdate (Optional)

Contact Phone Number

Email Address

Fired Have you ever been fired from a job? (Downsize and/or layoffs are not considered being fired.)

Arrests or Criminal Offenses Have you ever been arrested, pled guilty to or been convicted of any criminal offense other than a minor traffic violation?

Default on Educational Loans Are you currently in default on the repayment of any educational loan?

Detailed explanation required for “Yes” responses to the Fired, Criminal Offense, or Default on Educational Loans questions.

Name and Address of School 1 Name and Address of High School

Dates Attended (School 1) From (MO/YR) to (MO/YR)

Diploma or Equivalent Received

Date Received (MO/YR)

Name and Address of School 2Name and Address of College or University

Major (School 2)Do not abbreviate

Dates Attended (School 2)From (MO/YR) to (MO/YR)

Degree Earned (School 2)Level and Date of degree earned. Please include the level and (MO/YR).

Name and Address of School 3Name and Address

Major (School 3)Do not abbreviate

Dates Attended (School 3)From (MO/YR) to (MO/YR)

Degree Earned (School 3)Level and Date of degree earned. Please include the level and (MO/YR).

Name and Address of School 4Name and Address

Major (School 4)Do not abbreviate

Dates Attended (School 4)From (MO/YR) to (MO/YR)

Degree Earned (School 4)Level and Date of degree earned. Please include the level and (MO/YR).

Technical/Professional License(s)Please provide the license number, state issued, date issued (MO/YR), and the expiration date for your technical/professional license(s).

Employer 1

Address (Employer 1)

Telephone (Employer 1)

Title (Employer 1)

Employment Dates (Employer 1)(MO/YR) to (MO/YR)

Describe Duties and Responsibilities (Employer 1)

Reason for Leaving (Employer 1)

Salary (Employer 1)

Employer 2

Address (Employer 2)

Telephone (Employer 2)

Title (Employer 2)

Employment Dates (Employer 2)(MO/YR) to (MO/YR)

Describe Duties and Responsibilities (Employer 2)

Reason for Leaving (Employer 2)

Salary (Employer 2)

Employer 3

Address (Employer 3)

Telephone (Employer 3)

Title (Employer 3)

Employment Dates (Employer 3)(MO/YR) to (MO/YR)

Describe Duties and Responsibilities (Employer 3)

Reason for Leaving (Employer 3)

Salary (Employer 3)

Employer 4

Address (Employer 4)

Telephone (Employer 4)

Title (Employer 4)

Employment Dates (Employer 4)(MO/YR) to (MO/YR)

Describe Duties and Responsibilities (Employer 4)

Reason for Leaving (Employer 4)

Salary (Employer 4)

Agreement

What is your Sex?

Female
Male

What is your Race?

Verification

AttachmentsMultiple files can be uploaded by holding down Shift or Ctrl while selecting.

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Employment Application