Employment with the State of Florida
Note:ThishardcopyoftheStateof
Floridaemploymentapplicationisto
beusedonlyifyouareunable
tousetheonlineapplication
processathttps://jobs.
myflorida.com/index.html
State Government
Personnel Structure
Floridastategovernmentis
amajoremployerinFlorida
offeringmanychallengingand
rewardingcareeropportunities.
Includedamongthemanyadvantages
ofworkingfortheStatearethediverse
andinterestingjobopportunitiesaswell
ascompetitivesalaries,benefits,and
careermobility.
EmployeeswiththeStateofFlorida
fallintoavarietyofdifferentand
autonomouspersonnelsystems
eachwiththeirownsetofrulesand
regulations,collectivebargaining
agreements,andwageandbenefit
packages.TheStatePersonnel
System,comprisedofemployeesin
theCareerService,SelectedExempt
ServiceandSeniorManagement
Servicepayplans,isthelargestof
thesesystemsandisthefocusof
thisnarrative.TheStateofFlorida
employmentapplicationisusedtoapply
forvacancieswithintheStatePersonnel
System.
MoststatejobsareintheCareer
Servicepayplan.TheCareer
Serviceprovidesuniformpay,job
classification,benefitsandrecruitment
forthemajorityofnon-managerialjobs
withinstateagencies.TheSenior
ManagementService(SMS)includes
uppermanagementandpolicy-making
jobs.Middlemanagement,suchas
bureauchiefs,professionaljobs,such
asphysiciansandattorneys,and
supervisoryjobsareincludedinthe
SelectedExemptService.Employees
canmovebetweenagencieswithout
anylossofstatebenefits.
TemporaryjobsarefundedbyOther
PersonalServices(OPS)appropriations.
OPSemployeesreceiveanhourlywage
butnobenefitssuchasinsurance,
leave,orretirement.
Non-StatePersonnelSystem
agenciesareagencies
inwhichjobsdonotfall
undertheCareerService,
SelectedExemptService
orSeniorManagement
Servicepayplans
andtheiremployment
proceduresmaydiffer.
Theseemployersmayormay
notaccepttheStateofFlorida
employmentapplication.Additionally,
theirjobtitlesandsalariesmaynot
becomparabletothoseintheState
PersonnelSystem.
How to Search for Vacancies
Individualstateagenciesareresponsible
forannouncingtheirjobvacanciesand
makinghiringdecisions.Generally,
agenciesacceptjobapplicationsfor
advertisedvacanciesonly.However,
agenciesmayacceptapplications
forcertainpositionsonacontinuous
basis.AcompletedStateofFlorida
employmentapplicationisrequiredfor
eachjobvacancytowhichyouapply.
Thereareseveralwaysforyoutoobtain
statejobvacancyinformation:
•AccessthePeopleFirstjob informationwebsiteontheInternet
at:https://jobs.myflorida.com
• ContactindividualStatePersonnel
Systemagenciesdirectlyfor
informationregardingtheir
employmentopportunities.
• ContactaFloridaOneStopCareer
Centerforjobinformationonand
otheremploymentopportunities.To
locatetheofficenearestyou,check
yourtelephonedirectoryunder
“WorkforceOneStopCareerCenter”
orvisit:http://www.employflorida.net
Completedapplicationsshouldbe
submittedbyFAXtothePeopleFirst
ServiceCenterat904/636-2627.
How to Market Yourself
Priortocompletinganapplicationfor
anyjob,gatherspecificinformation
aboutthedutiesofthejobandrelevant
knowledge,skillsandabilitiesrequired
bycarefullyreviewingthejobvacancy
announcementorbycontactingthe
employingagency,ifnecessary.
Usethisinformationtoensureyour
application,coverletter,resumeand
othersupportingmaterialsaddresshow
yourexperienceandeducationfulfill
theserequirements.
How Candidates are
Selected
Thefirststepanemployingagency
takesintheselectionprocessisto
reviewtheapplicationswhichhave
beenreceivedtodeterminewho
iseligibletocompetefurtherinthe
selectionprocess.Job-relatedcriteria
areusedtodeterminethoseapplicants
whowillbeaskedtoparticipatein
additionalassessmentstepssuchasan
oralinterview,aworksampleexercise,
oraproficiencytest.Thejob-related
informationgainedduringtheselection
processwillassistthehiringofficial
inmakingthefinalselectiondecision.
Veterans’preferenceandAffirmative
Actiongoalsarealsoconsideredbythe
agencyinthedecision-makingprocess.
If, because of a disability, you
require a special accommodation
to participate in the application and
selection process, please notify the
hiring authority in advance.
#
Employer,removethissectionuponcompletionoftheselectionprocess.
YOURNAME:_____________________________________________________________________________________________________________________________
POSITIONTITLEFORWHICHYOUAREAPPLYING: _________________________________________________________ POSITIONNUMBER: ________________
VETERANS’PREFERENCEINFORMATION:(CareerServicepositionsonly)Forthepurposesofappointments,retention,reinstatementand
reemployment,Veterans'Preferenceensuresthatveteransandeligiblespousesofveteransaregivenconsiderationateachstepoftheselectionprocess.However,
preferencedoesnotguaranteethataveteranortheeligiblespouseofaveteranwillbethecandidateselectedtofilltheposition.CompletionoftheVeterans'Preference
sectionbelowismadeonavoluntarybasisandkeptconfidentialinaccordancewiththeAmericanswithDisabilitiesAct.ListedbelowarethefiveVeterans'
Preferencecategories.
1. Aveteranwithaservice-connecteddisabilitywhoiseligiblefororreceivingcompensation,disabilityretirement,orpensionunderpubliclawsadministeredbytheU.S.
DepartmentofVeterans’AffairsandtheDepartmentofDefense,or
2. Thespouseofaveteranwhocannotqualifyforemploymentbecauseofatotalandpermanentservice-connecteddisability,orthespouseofaveteranmissinginaction,
captured,orforciblydetainedorinternedinthelineofdutybyaforeignpower, or
3. Aveteranofanywarwhohasservedonactivedutyforonedayormoreduringawartimeperiod,excludingactivedutyfortraining,andwhowasdischargedunder
honorableconditionsfromtheArmedForcesoftheUnitedStatesofAmerica,or
4. Theunremarriedwidoworwidowerofaveteranwhodiedofaservice-connecteddisability,or
5.
Aveteranwhohasservedinaqualifyingcampaignorexpeditionforwhichacampaignbadgeorexpeditionarymedalhasbeenauthorized;includinganyArmedForces
ExpeditionaryMedalorGlobalWaronTerrorismExpeditionaryMedal.
Thereceiptofacampaignmedalisnotrequired,onlyserviceduringawartimeperiod.Wartimeperiodsaredefinedin§1.01,F.S.Veterans'Preferencemayonlybegiven
tonon-stateemployeesorcurrentstateemployeesapplyingtopositionsoutsidetheircurrentagencyorpoliticalsubdivision.Veterans’PreferenceisonlyavailabletoFlorida
residents.
ADD214orcomparabledocumentwhichservesasacertificateofreleaseordischargeandanyotherrequiredsupportingdocumentationmustbefurnishedatthetimeof
application.PleaseFAXsupportingdocumentationtothePeopleFirstServiceCenterat904/636-2627bytheclosingdateoftheadvertisement.
Besuretoincludethepositionnumberforwhichyouareapplying.InadditiontotheDD214,applicantsclaimingcategories1,2,or4abovemustfurnishsupporting
documentationinaccordancewiththeprovisionsofRule55A-7.013,F.A.C.UnderFloridalaw,preferenceinappointmentshallbegivenfirsttothosepersonsincategories1
and2andthentothoseincategories3,4and5.
IfaqualifiedapplicantclaimingVeterans’Preferenceforavacantpositionisnotselected,he/shemayfileacomplaintwiththeFloridaDepartmentofVeterans’Affairs,11351
UlmertonRoad,Largo,FL33778.Acomplaintmustbefiledwithin21daysoftheapplicantreceivingnoticeofthehiringdecisionmadebytheemployingagencyorwithin3
monthsofthedatetheapplicationisfiledwiththeemployerifnonoticeisgiven.
VETERANS’PREFERENCECLAIM:IFELIGIBLE,WHICHVETERANS’PREFERENCECATEGORY
AREYOUCLAIMING?(PleaseindicatenumberfromVeterans’PreferenceInformationsectionabove.)
AREYOUCURRENTLYEMPLOYEDINACAREERSERVICEPOSITIONWITHTHEAGENCYTOWHICHYOU
ARECURRENTLYAPPLYING?
YES
NO
AREYOUARESIDENTOFTHESTATEOFFLORIDA?
YES
NO
YES
NO
HAVEYOURECEIVEDAPROMOTIONALAPPOINTMENT,SUBSEQUENTTOACTIVEMILITARYSERVICE,
WITHTHEAGENCYTOWHICHYOUARECURRENTLYAPPLYING?
#
EmployerMUSTremovethissectionpriortotheselectionprocess.Thisinformationmustberetainedbytheagencypersonneloffice.
EEOSURVEYAlthoughthefollowinginformationisnotmandatory,itisrequestedtoaidtheStateofFloridainitscommitmenttoEqualEmploymentOpportunity,AffirmativeActionand
tomeetfederalreportingrequirements.Refusaltoanswerwillnotresultinadversetreatmentofanyapplicant.Applicantswhobelievetheyhavebeendiscriminatedagainstmayfileacomplaintwith
theFloridaCommissiononHumanRelations,2009ApalacheeParkway,Tallahassee,Florida32301.
POSITIONTITLEFORWHICHYOUAREAPPLYING: _____________________________________________________________________________________________
POSITIONNUMBER:_______________________________________________________________________________________________________________________
SEX:
DATEOFBIRTH:
_____________________________________
MALE FEMALE
RACE/ETHNICITY(CHECKONLYONE):
HispanicorLatino-ApersonofCuban,Mexican,PuertoRican,SouthorCentralAmerican,orotherSpanishcultureororigin,regardlessofrace.
White(notHispanicorLatino)-ApersonhavingoriginsinanyoftheoriginalpeoplesofEurope,theMiddleEastorNorthAfrica.
BlackorAfricanAmerican(notHispanicorLatino)-ApersonhavingoriginsinanyoftheblackracialgroupsofAfrica.
NativeHawaiianorOtherPacificIslander(notHispanicorLatino)-ApersonhavingoriginsinanyofthepeoplesofHawaii,Guam,Samoa,orotherPacificIslands.
Asian(notHispanicorLatino)-ApersonhavingoriginsinanyoftheoriginalpeoplesoftheFarEast,SoutheastAsia,ortheIndianSubcontinent,including,forexample,
Cambodia,China,India,Japan,Korea,Malaysia,Pakistan,thePhilippineIslands,Thailand,andVietnam.
AmericanIndianorAlaskaNative(notHispanicorLatino)-ApersonhavingoriginsinanyoftheoriginalpeoplesofNorthandSouthAmerica(includingCentralAmerica),
andwhomaintaintribalaffiliationorcommunityattachment.
TwoorMoreRaces(notHispanicorLatino)-Allpersonswhoidentifywithmorethanoneoftheabovesixcategories.
5
StateofFlorida
FOR OFFICIAL USE ONLY
EMPLOYMENT
APPLICATION
AgencyAuthorizedSignature
Broadband/ClassCode
Status
POSITION APPLIED FOR
Agency:___________________________________________________________________________
EqualOpportunityEmployer/AffirmativeActionEmployer
TheStateofFloridadoesnottolerateviolenceintheworkplace.
Title:______________________________________________________________________________
Where to Find Vacancy Information:
• OntheInternet:https://peoplefirst.myflorida.com
• OneStopCareerCenters - Consult your local telephone directory or visit
http://www.employflorida.net
• StateAgencyPersonnelOffices
GENERAL INSTRUCTIONS FOR COmPLETION OF APPLICATION:
Date
PositionNumber:___________________________ DateAvailable: ____________________________
CountiesofInterest: _________________________________________________________________
MinimumAcceptableSalary: __________________________________________________________
HOW DO WE CONTACT YOU?
• Completethisapplicationinitsentirety.
• Typeorprintinink.
YourName
• Inaccordancewiths.119.071(5)(a)2,F.S.,yourSocialSecurityNumber
maybecollectedforthepurposeofassistingwithpre-employment
eligibilityscreeningandtoprocessyourapplication.
SocialSecurityNumber
PeopleFirstEmployeeIDNumber(ifany)
• Specifythepositionforwhichyouareapplying.(Note:Aseparate
applicationmustbesubmittedforeachvacancy.Photocopiesare
acceptable.)
• SubmitapplicationtothePeopleFirstServiceCenter,
FAX:904/636-2627,nolaterthan11:59PM(EST)ontheannounced
deadlinedate.
• SignyournameintheCertificationSection(page4).Allinformationyou
submitissubjecttoverification.
YourMailingAddress
City
County
HomePhone
BusinessPhone
StateZipCode
CellPhone
E-mailAddress
EDUCATION
HIGHSCHOOL:
NAME/LOCATIONOFSCHOOL
rECEIVED:
Diploma
Other(specify)
None
YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL:________________________________________________________________________________________________________________ COLLEGE,UNIVErSITYOrPrOFESSIONALSCHOOL:(TrANSCrIPTSMAYBErEqUIrED)
NAMEOFSCHOOL
LOCATION
DATESOF ATTENDANCE
(MONTH/YEAr)
FrOM
TO
CrEDIT HOUrS EArNED qTr SEM
MAJOr/MINOr
COUrSEOF
STUDY
TYPEOF
DEGrEE
EArNED
YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL: ________________________________________________________________________________________________________________
JOB-rELATEDTrAININGOrCOUrSEWOrK:(VOCATIONAL,TrADE,GOVErNMENTAL,BUSINESS,ArMEDFOrCES,ETC.)
NAMEOFSCHOOL
LOCATION
DATESOF ATTENDANCE
(MONTH/YEAr)
CrEDIT HOUrS EArNED COUrSEOF
STUDY
TrAINING
COMPLETED
YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL: ________________________________________________________________________________________________________________
LICENSUrE,rEGISTrATION,CErTIFICATIONEXAMPLES:DriverLicense,TeacherCertification,rN,LPN,PE,CPA,etc.
LICENSE,rEGISTrATIONOrCErTIFICATION:
Number
1 1
Datereceived
ExpirationDate
StateLicensingAgency
PERIODSOFEMPLOYMENT
Describeallworkexperienceindetail,beginningwithyourcurrentormostrecentjob.Includemilitaryservice(indicaterank),internshipsandjob-relatedvolunteerwork,ifapplicable.Indicatenumber
ofemployeessupervised.Useaseparateblocktodescribeeachpositionorgapinemployment.Ifneeded,attachadditionalsheets,usingthesameformatasontheapplication.Allinformationinthis
sectionmustbecompleted.Resumesmaybeattachedtoprovideadditionalinformation.
1
NameofPresentorLastEmployer:_____________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
MONTH
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving: ____________________________________________________________________________________________________________________
2
NameofNextPreviousEmployer:______________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
MONTH
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving: ____________________________________________________________________________________________________________________
3
NameofNextPreviousEmployer:______________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
MONTH
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving: ____________________________________________________________________________________________________________________
2
4
NameofNextPreviousEmployer:______________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
MONTH
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving: ____________________________________________________________________________________________________________________
5
NameofNextPreviousEmployer:______________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving:____________________________________________________________________________________________________________________ MONTH
6
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
NameofNextPreviousEmployer:______________________________________________________________________________________________________
Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________
FROM:_____/_____/_____TO:_____/_____/_____HOURSPERWEEK:_______(_________________________)
MONTH
DAY
YEAR
MONTH
DAY
YEAR
YOURNAMEIFDIFFERENTDURINGEMPLOYMENT
DutiesandResponsibilities: ______________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________
ReasonForLeaving: ____________________________________________________________________________________________________________________
Ifneeded,attachadditionalsheets,usingthesameformatasontheapplication.Resumesmaybeattachedtoprovideadditionalinformation.
3 3
KNOWLEDGE/SKILLS/ABILITIES(KSAs)
ListKSAsyoupossessandbelieverelevanttothepositionyouseek,suchasoperatingheavyequipment,computerskills,fluencyinlanguage(s),etc.
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
EXEMPTIONFrOMPUBLICrECOrDSDISCLOSUrE
ArEYOUACUrrENTOrFOrMErLAWENFOrCEMENTOFFICEr,OTHErEMPLOYEE**OrTHESPOUSE
OrCHILDOFONE,WHOISEXEMPTFrOMPUBLICrECOrDSDISCLOSUrEUNDEr§119.071,F.S.?
YES
NO
**Othercoveredjobsinclude:correctionalandcorrectionalprobationofficers,firefighters,certainjudges,assistantstateattorneys,stateattorneys,assistantandstatewide
prosecutors,personneloftheDepartmentofrevenueorlocalgovernmentswhoseresponsibilitiesincluderevenuecollectionandenforcementorchild
supportenforcement,andcertaininvestigatorsintheDepartmentofChildrenandFamilies[see§119.071,F.S.].
BACKGrOUNDINFOrMATION
HAVEYOUEVErBEENCONVICTEDOFAFELONYOrAFIrSTDEGrEEMISDEMEANOr?
YES
NO
If“YES”,whatcharges? _____________________________________________________________________________________________________________________
Whereconvicted?_________________________________________________________________ DateofConviction:______________________________________
HAVEYOUEVErPLEDNOLOCONTENDErEOrPLEDGUILTYTOACrIMEWHICHISA
FELONYOrAFIrSTDEGrEEMISDEMEANOr?
YES
NO
If“YES”,whatcharges?______________________________________________________________________________________________________________________
Where? _________________________________________________________________________ Date: ________________________________________________
HAVEYOUEVErHADTHEADJUDICATIONOFGUILTWITHHELDFOrACrIMEWHICHISA
FELONYOrAFIrSTDEGrEEMISDEMEANOr?
YES
NO
If“YES”,whatcharges? ____________________________________________________________________________________________________________________
Where? __________________________________________________________________________ Date:_________________________________________________
NOTE:A“YES”answertothesequestionswillnotautomaticallybaryoufromemployment.Thenature,job-relatedness,severityanddateoftheoffenseinrelationto
thepositionforwhichyouareapplyingareconsidered[see§112.011,F.S.]
CITIZENSHIP
TheStateofFloridahiresonlyU.S.citizensandlawfullyauthorizedalienworkers.Ifaconditionalofferofemploymentismade,youwillberequiredtoprovideidentification
andproofofcitizenshiporauthorizationtoworkintheU.S.
ArEYOUAU.S.CITIZENOrArEYOULEGALLYAUTHOrIZEDTOWOrKINTHEU.S.?
YES
NO
YES
NO
YES
NO
rELATIVES
TOYOUrKNOWLEDGE,DOYOUHAVEANYrELATIVESWOrKINGINTHISAGENCY?
SELECTIVESErVICESYSTEMrEGISTrATION
Allmalesbetweentheagesof18and26mustberegisteredwiththeSelectiveServiceSystemorexempted.
IFYOUArEAMALEBETWEENTHEAGESOF18AND26,DOYOUHAVEPrOOFOFrEGISTrATION
WITHTHESELECTIVESErVICESYSTEMOrEXEMPTIONFrOMSUCHrEGISTrATION?
CErTIFICATION
I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employment consideration and, if I am
hired,maybegroundsforterminationatalaterdate.IunderstandthatanyinformationIgivemaybeinvestigatedasallowedbylaw.Iconsenttothereleaseofinformationaboutmyability,employmenthistory,andfitnessforemploymentbyemployers,schools,lawenforcementagencies,andotherindividualsandorganizationsto
investigators,personnelstaff,andotherauthorizedemployeesofFloridastategovernmentforemploymentpurposes.Thisconsentshallcontinuetobeeffectiveduring
myemploymentifIamhired.Iunderstandthatapplicationssubmittedforstateemploymentarepublicrecordsexceptasexemptedabove.Icertifythattothebestofmy
knowledgeandbeliefallofthestatementscontainedhereinandonanyattachmentsaretrue,correct,complete,andmadeingoodfaith.
SIGNATUrE: ___________________________________________________________________________ DATE: ___________________________________
4
DP-E-16rev.0308