application by chrstphr

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									 HILLSBOROUGH COUNTY                                                                                                                                  1
                                                                                           THIS SPACE FOR CIVIL SERVICE USE ONLY
 CIVIL SERVICE BOARD                                                                    LIST _________________________________________
 APPLICATION FOR EMPLOYMENT                                                                                                       O          C
           HILLSBOROUGH COUNTY CIVIL SERVICE BOARD
           P.O. BOX 1110                                                                CERTIFICATION DATE ________________________
           TAMPA, FLORIDA 33601
                                                                                        Typing ____________(Net WPM) Date _____________
  NOTICE: PRINT CLEARLY IN INK OR TYPE. Resumes are NOT ac-
  cepted. Only information contained in this form will be used to evaluate              Data Entry ________ (Net KSPM) Date ____________
  your education and experience. Please read the APPLICATION INSTRUC-
  TIONS before completing this form. Answer all questions completely.                                      % Accuracy ________
  Where appropriate, answer questions with "Yes" or "No" or "None." Do
  NOT use "NA" or dashes. List the jobs you are applying for on Page 4.


Full Name ___________________________________________________________________                        SSN
           Last                              First               MI

Mailing Address ________________________________________________________________________________________________________
                  Number               Street             Apt. Number              City               State     Zip Code

*Business Phone: (           )                   (*Only if you will accept employment calls)         Home Phone: (         )
   VETERANS' PREFERENCE: Please read the Veterans' Preference in Employment Information Sheet (CS Form 22).
   Are you claiming veterans' preference? YES     NO ALL APPLICIANTS MUST ANSWER THIS QUESTION!
   Basis for the claim:   Active Duty during Wartime Era            Disabled Veteran          Spouse of Eligible Veteran   Unremarried Spouse
   Have you been employed by the State of Florida or a political subdivision of the State following military service?         YES         NO
   If you are claiming preference, please initial to show you reviewed CS Form 22 __________.


I am interested in:          Full-Time           Temporary           Part-Time            Evenings           Weekends             Nights
(You may check any or all)

                                                          EDUCATION INFORMATION
    SCHOOLS                  Name and Address (City & State) of School                             Answer for each school attended
                                                                                  Did you graduate?      YES         NO
  Elementary
                                                                                  If NO, do you have a GED Certificate?    YES     NO
      or
  High School                                                                             GED issued by (State): _________________________
                                                                                  Circle Highest Grade Completed: 6 7 8 9 10 11 12
                                                                                  Did you graduate?       YES        NO
  College or                                                                      Credits Completed: Sem. Hrs. ______ Qtr. Hrs. _______
  University                                                                      Major ________________ Minor __________________
  (See footnote)                                                                  Type Degree Received: AA AS BA BS               (Circle One)
                                                                                  Did you graduate?       YES        NO
  College or
                                                                                  Credits Completed: Sem. Hrs. ______ Qtr. Hrs. _______
  University
                                                                                  Major ________________ Minor __________________
  (See footnote)
                                                                                  Type Degree Received: AA AS BA BS (Circle One)
  Graduate School                                                                 Did you graduate?       YES        NO
  or Additional                                                                   Credits Completed: Sem. Hrs. ______ Qtr. Hrs. _______
  College/Univ.                                                                   Major ________________ Minor __________________
  (See footnote)                                                                  Type Degree Received: MA MS PhD Other ___ (Circle One)
                                                                                                                           Field of Study
  Vocational/                                                                     Total Hours:
  Business
                                                                                  Total Months:
                                                                                                                     Completed?        Yes       No
                                                                                  Total Hours:                             Field of Study
  Other
                                                                                  Total Months:

FOOTNOTE: Copy of degree or official transcript required as proof.
                         In accordance with State and Federal law, Hillsborough County does not discriminate
                         on the basis of age, race, religion, color, sex, national origin, marital status or disability.          CS Form 1-I (08/00)
                                                PLEASE TYPE OR PRINT CLEARLY IN INK.                                                                            2
PRINT                        ANSWER ALL QUESTIONS WITH "YES", "NO" OR "NONE", DO NOT USE "NA" OR DASHES
FULL
NAME                                                                                                        SSN
             Last                                                  First                  MI

List any language(s) you SPEAK, other than English:
List any language(s) you WRITE, other than English:

A "Yes" answer to the questions in this box will not necessarily bar you from employment. If you are not a U.S. Citizen, you will be required to provide legal
proof of employability. The nature, severity, and date of any convictions will be considered in relation to the duties of the position for which you are applying.
Are you       a U.S. Citizen OR        an alien authorized to work in the United States? (check only one box.)
Have you ever pled guilty, been convicted of OR pled nolo contendere to any crime?           Yes        No
Do you currently have any Law violations pending against you?           Yes        No
If you answered Yes to either Law violation question, please describe the type of crime, date of conviction, location, and penalty imposed. You may
omit (1) minor traffic violations; and (2) any offense committed as a minor which was adjudicated in a juvenile court or under a youth offender law:

 Have you ever been a defendant in a civil action for an intentional tort?    Yes              No         If yes, indicate the nature of the intentional tort
 and the disposition of the action:
A "Yes" answer to the following question will not bar you from employment, nor does it infer preferential hiring. This information is used
only to ensure the enforcement of anti-nepotism laws, Section 112.313, Florida Statutes.
 Do you have relatives working for Hillsborough County Government?                  Yes        No     If yes, list Names, Relationship and Department/Agency:



Do you have a valid Driver License?           Yes    No State: ______________ Circle Class of License:                    A      B   C            D       E
Type of license:    Noncommercial             Commercial  (Circle all endorsements: T   N      P    H                      X    E None)
Driver license number:

List your current occupational and professional licenses and certificates:         (Indicate Type, State of Issue, Original Issue Date, and Expiration Date)




Do you now or have you previously worked for Hillsborough County Government?                        Yes      No    If yes, list Dates and Department/Agency:


                             EMPLOYMENT AND UNEMPLOYMENT HISTORY INFORMATION

List ALL periods of employment and unemployment, starting with today, and working backward to your earliest employment. Use a SEPARATE block for
each position you have held, even though it may have been with the same employer. When describing your work be as detailed as possible and avoid using
uncommon abbreviations. If additional space is needed, Civil Service Board employment history continuation sheets must be used.

Name and Mailing Address of Company:                                         Dates Employed (Month and Year) Hours worked Number of employees
                                                                             From:                           per week:    you supervised:
Phone Number: (          )                                                   To:

Your Job Title:                                                              Name and Title of Your Supervisor
 Webmaster
 Describe Your Work in Detail




Machines or equipment you used in your work:                                                        Reason for Leaving:
                                  USE THIS SPACE BEFORE USING SUPPLEMENTAL EMPLOYMENT HISTORY PAGES                                         3
  PRINT
  FULL
  NAME                                                                                        SSN
             Last                                           First             MI
  Name and Mailing Address of Company:                              Dates Employed (Month and Year) Hours worked Number of employees
                                                                    From:                           per week:    you supervised:
  Phone Number: (       )                                           To:

  Your Job Title:                                                   Name and Title of Your Supervisor


   Describe Your Work in Detail




  Machines or equipment you used in your work:                                         Reason for Leaving:



 IMPORTANT!! I acknowledge by my signature that I have read and understand the following:
* Only information contained on this form, official addendum sheets and application supplemental forms will be used to evaluate my
   qualificatiaons. Resumes or information contained on other than Hillsborough County Civil Service Board job application forms are not
   accepted or used.
* Qualification and employment considerations by Hillsborough County are based upon the truthfulness and completeness of the
   statements in this application. Falsification or omission of information are grounds for disqualification or dismissal. On submission, this
   application, addendum sheets, and other required documentation to support employability become the property of the Civil Service Board
   and are matters of public record subject to release to other persons or agencies, upon request. Presenting any false document(s) to gain
   employment may be cause for ineligibility for hire or immediate dismissal and the filing of criminal charges.
* My name and a copy of my application will be referred to each hiring authority as long as I remain on the certified list of eligibles. I may
   or may not be interviewed; that decision rests with the hiring authority NOT the Civil Service Office.
* I authorize Hillsborough County and the Hillsborough County Civil Service Board to investigate the truthfulness of all statements made
   on this application and to contact my former employers and other listed references or other persons who can verify information.
 * I hereby consent to the use of my social security number for county business. Disclosure of social security numbers are required for
   employment by Federal law. Social security numbers are used for tracking applications and, if hired, for complying with Federal tax and
   immigration laws.
* I give my consent for all contacted persons, including former employers, to provide information concerning this application and I release
   each person from liability for providing such information. I waive all causes of action that might arise from the foregoing.
* If hired by any agency serviced by Hillsborough County Civil Service Board, I must present documentation to substantiate my eligibility
   for employment and complete an Immigration and Naturalization Service (INS) Form 9 attesting to employability.
* A post-employment offer physical examination and/or drug and alcohol testing may be required as a condition of employment and
   continued employment.
* I am aware that Hillsborough County employees are placed on a minimum six months initial probationary period, during which time either
   the employing agency or I can terminate my employment, with or without cause, and with or without notice, at any time.
* I acknowledge that the ORIGINAL APPLICATION FORM, ADDENDUMS AND APPROPRIATE SUPPLEMENTAL FORMS MUST BE
   SIGNED in order to be processed or evaluated.



  Signature_________________________________________________________________ Date ________________________________________
  DO NOT REMOVE COMPLETED APPLICATIONS FROM THIS OFFICE!!!                                                    PLEASE TURN PAGE
                                                PRINT
SSN                                             FULL
                                                NAME      Last                                            First                           MI


Mailing                                                                                              HOME
            Number          Street                               Apt. Number
Address:                                                                                             PHONE

            City                        State                    Zip Code

Are you a classified
Hillsborough County Civil Service Employee?         YES          NO         If YES, what Agency/Department?

                     INDICATE THE JOBS                                           BOLD BORDERED AREA IS FOR CIVIL SERVICE USE ONLY                                              Agency:
                   YOU ARE APPLYING FOR                                          B/D: _____________ Vet: _______
                                                                                                      S
  Today's                  COMPLETE JOB TITLE                Class Code                    CS         t       C
                                                                                                                  T                            Typing/Data Entry
                                                                                   Test          T    a       o       Test    Written Test                           Final    Certification
   Date                      (As shown on Bulletin)          (List 6 digits)              Emp                 d                                Results & Accuracy
                                                                                   Date          R    t           Q    #     Results & Date                         Results       Date
 MM/DD/YY            (USE ONE BLOCK FOR EACH JOB TITLE)       (A1234-0)                   Init        u       e                                      & Date
                                                                                                      s



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                                                                                                                                                                                         4
                   EQUAL EMPLOYMENT OPPORTUNITY INFORMATION        5
                           FOR STATISTICAL USE ONLY

Please complete this form and return it with your Application
for Employment.

SOCIAL SECURITY NUMBER:           --44-       --

NAME:                                   DATE OF APPLICATION:
        LAST         FIRST     MIDDLE

In order to compile information for Equal Employment Opportunity
(EEO) statistical reports, we request you provide the following
information. This data will not be kept with the application
form, nor used in the decision to hire.       Completion of the
following is voluntary and you may elect to leave any or all
blocks blank.

DATE OF BIRTH:                      GENDER:        MALE        FEMALE

RACE/ETHNIC CATEGORY (CHECK ONE BLOCK ONLY):
          American Indian/Alaskan Native: All persons having
          origins in any of the original peoples of North
          America, and who maintain cultural identification
          through tribal affiliation or community recognition.

               Hispanic: All persons of Mexican, Puerto Rican, Cuban,
               Central or South American, or other Spanish culture or
               origin, regardless of race.

                Black (not of Hispanic origin): All persons having
               origins in any of the Black racial groups of Africa.

               White (Non-Hispanic origin): All persons having
               origins in any of the original peoples of Europe,
               North Africa, or the Middle East.

               Asian or Pacific Islander: All persons having origins
               in any of the original peoples of the Far East,
               Southeast Asia, the Indian Subcontinent, or the
               Pacific Islands. This area includes, for example,
               China, India, Japan, Korea, the Philippine Islands,
               and Samoa.



(CS Form 1d 8/00)
                        SUPPLEMENTAL JOB APPLICATION EMPLOYMENT HISTORY PAGE                       6
USE SUPPLEMENTAL PAGES ONLY AFTER FILLING THE TWO EMPLOYMENT HISTORY SPACES ON THE BASIC APPLICATION
                  THIS PAGE MUST BE SIGNED TO BE ACCEPTED BY THE CIVIL SERVICE OFFICE

PRINT
FULL                                                                            SSN
NAME              Last                 First                     MI
Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




THIS FORM MUST BE SIGNED IN ORDER TO BE EVALUATED. The acknowledgements on the basic application form are applicable to this
page. I have read and understand them.
Signature_________________________________________________________________ Date ________________________________________
                                                                                                                 CS Form 1b-I (08/00)
                        SUPPLEMENTAL JOB APPLICATION EMPLOYMENT HISTORY PAGE                       6
USE SUPPLEMENTAL PAGES ONLY AFTER FILLING THE TWO EMPLOYMENT HISTORY SPACES ON THE BASIC APPLICATION
                  THIS PAGE MUST BE SIGNED TO BE ACCEPTED BY THE CIVIL SERVICE OFFICE

PRINT
FULL                                                                            SSN
NAME              Last                 First                     MI
Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




THIS FORM MUST BE SIGNED IN ORDER TO BE EVALUATED. The acknowledgements on the basic application form are applicable to this
page. I have read and understand them.
Signature_________________________________________________________________ Date ________________________________________
                                                                                                                 CS Form 1b-I (08/00)
                        SUPPLEMENTAL JOB APPLICATION EMPLOYMENT HISTORY PAGE                       6
USE SUPPLEMENTAL PAGES ONLY AFTER FILLING THE TWO EMPLOYMENT HISTORY SPACES ON THE BASIC APPLICATION
                  THIS PAGE MUST BE SIGNED TO BE ACCEPTED BY THE CIVIL SERVICE OFFICE

PRINT
FULL                                                                            SSN
NAME              Last                 First                     MI
Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




THIS FORM MUST BE SIGNED IN ORDER TO BE EVALUATED. The acknowledgements on the basic application form are applicable to this
page. I have read and understand them.
Signature_________________________________________________________________ Date ________________________________________
                                                                                                                 CS Form 1b-I (08/00)
                        SUPPLEMENTAL JOB APPLICATION EMPLOYMENT HISTORY PAGE                       6
USE SUPPLEMENTAL PAGES ONLY AFTER FILLING THE TWO EMPLOYMENT HISTORY SPACES ON THE BASIC APPLICATION
                  THIS PAGE MUST BE SIGNED TO BE ACCEPTED BY THE CIVIL SERVICE OFFICE

PRINT
FULL                                                                            SSN
NAME              Last                 First                     MI
Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




Name and Mailing Address of Company:                       Dates Employed (Month and Year) Hours worked Number of employees
                                                           From:                           per week:    you supervised:

Phone Number: (      )                                     To:

Your Job Title:                                            Name and Title of Your Supervisor


Describe Your Work in Detail




Machines or equipment you used in your work:                                 Reason for Leaving:




THIS FORM MUST BE SIGNED IN ORDER TO BE EVALUATED. The acknowledgements on the basic application form are applicable to this
page. I have read and understand them.
Signature_________________________________________________________________ Date ________________________________________
                                                                                                                 CS Form 1b-I (08/00)
VETERANS' PREFERENCE IN EMPLOYMENT

NOTE: This is the CS Form 22 referred to in the Application for Employment.
Please read before checking the YES or NO block on the application. If you are
claiming preference, please respond to all questions in the Veterans' Preference
block and initial the application to indicate you have received a copy of this
form. Also, please retain this form for future reference.

POLICY: It is the policy of the State of Florida to give preference to eligible
veterans, who have been separated from the service of the United States, and
eligible spouses of veterans in initial appointment to positions of public
employment. Hillsborough County, a political subdivision of the state, is not a
scored system for employment purposes and, therefore, gives special consideration
to eligible veterans and eligible spouses of veterans in each step of the
employment selection process. In unscored systems, employers are NOT required to
employ a preferred applicant over a non-preferred applicant who is the most
qualified applicant for the position. The employer IS required to document and
justify the decision to hire a non-preferred applicant. This policy does not
apply to current classified employees of Hillsborough County except during
periods of reduction in force (RIF) when preference in retention may be claimed.
Otherwise, the Department of Veteran's Affairs has determined that the selection
of a current employee for another position within the same personnel system is
considered either a promotion, demotion, or reassignment; not initial
appointment.

VETERANS' PREFERENCE: Shall only be granted to eligible veterans and eligible
spouses who meet the minimum qualifications for the classification they have
applied.

ELIGIBILITY: ONLY RESIDENTS OF THE STATE OF FLORIDA WHO FALL IN ONE OF THE
FOLLOWING CATEGORIES SHALL BE ELIGIBLE TO RECEIVE SPECIAL CONSIDERATION IN
INITIAL APPOINTMENT:

ACTIVE DUTY DURING WARTIME ERA: A veteran of any war, as defined below, who was
discharged or separated therefrom under honorable conditions if any part of such
active duty was performed during the wartime era. Active duty for training shall
not be allowable.      REQUIRED DOCUMENTATION: A DD Form 214 or equivalent
certification from the Veterans Administration showing military status, inclusive
periods of service and discharge type or character of service. For the purpose
of this rule, "war" or "war-time" era (subsequent to World War I) means:

World War II: December 7, 1941 to December 31, 1946;

Korean Conflict: June 27, 1950 to January 31, 1955;

Vietnam Era: February 28, 1961 to May 7, 1975

Persian Gulf War: August 2, 1990 and ending on the date thereafter prescribed by
presidential proclamation or by law.

      DISABLED VETERANS: Veterans who have served on active duty in any branch
of the U.S. Armed Forces and who have a presently existing service-connected
permanent disability which is compensable, or are receiving compensation,
disability retirement benefits, or pension by reason of public laws, administered
by the Veteran's Administration and the Department of Defense. REQUIRED
DOCUMENTATION: A DD Form 214 or equivalent certification from the Veterans
Administration showing military status, inclusive periods of service and
discharge type. Also, a document from the Department of Defense, the Veterans
Administration, or the Division of Veterans Affairs, dated within the last year,
certifying the veteran has a service-connected disability, the percentage of
disability, and that compensation is being received.



CS Form 22 (Jul 00)
      SPOUSE OF ELIGIBLE VETERAN: The spouse of any person who has a total and
permanent service-connected disability and who, because of the disability, cannot
qualify for employment. REQUIRED DOCUMENTATION: A DD Form 214 or equivalent
certification from the Veterans Administration showing military status, inclusive
periods of service and discharge type. Also, a certification from the Department
of Defense or the Veterans Administration that the veteran is totally and
permanently disabled, or an identification card issued by the Division of
Veterans' Affairs.    Spouses shall also furnish evidence of marriage to the
veteran and a statement that the spouse is still married to the veteran at the
time of the application for employment. In addition, the spouse shall submit
proof that the disability is service connected and that the disabled veteran
cannot qualify for employment because of the service connected disability.

      The spouse of any person who is missing in action, captured in line of
duty by a hostile force, or forcibly detained or interned in line of duty by a
foreign government or power.     REQUIRED DOCUMENTATION: A document from the
Department of Defense or the Veterans Administration certifying that the person
on active duty is listed as missing in action, captured in line of duty, or
forcibly detained or interned in line of duty by a foreign government or power.
 Also, evidence of marriage and a statement that the spouse is married to the
person on active duty at the time of application for employment.

      UNREMARRIED SPOUSE: The unremarried widow or widower of a veteran who dies
of a service connected disability. REQUIRED DOCUMENTATION: A document from the
Department of Defense or the Veterans Administration certifying the service-
connected death of the veteran, evidence of marriage and a statement that the
spouse is not remarried.

NON-APPLICABILITY: Preference does not apply to applicants still on active duty
or those in a terminal leave status. Also, preference provided herein shall not
apply to individuals who have been classified as a deserter or to individuals who
have received a discharge under less than honorable conditions.

EXPIRATION OF VETERANS' PREFERENCE: A veteran's employment preference shall be
deemed to have expired after an eligible person has applied and been employed by
the state or any agency of a political subdivision of the state.

DOCUMENTATION OF VETERANS' PREFERENCE: The applicant claiming preference is
responsible for providing a legible copy of documentation to support
entitlement to preference AT THE TIME OF MAKING APPLICATION for a vacant
position. Any document issued by the Veterans' Administration to support
eligibility as a disabled veteran MUST be dated within the last year. All
documents must clearly indicate that they are copies of originals.

INVESTIGATIONS: Preferred eligible applicants have the right to an investigation
if a non-preferred eligible applicant is appointed to a position.

When notice of a hiring decision is given by an Appointing Authority, the
investigation request shall be filed within 21 calendar days from the date that
the notice is received by the applicant. When the applicant has not received
notice of a hiring decision within two calendar months of the receipt of the
application by the employer, the applicant shall contact the employer to
determine if the position has been filled by a non-preferred applicant. After
having determined from information supplied by the employer that the position has
been filled by the appointment of a non-preferred applicant, the preferred
applicant may file a complaint within three calendar months of the date the
application was received by the employer. If the position has not been filled,
the time period for filing a complaint is extended to provide the preferred
applicant one calendar month after having determined that the position has been



CS Form 22 (Jul 00)
filled. It is the responsibility of the preferred applicant to maintain contact
with the employer to determine if the position has been filled.

Request for investigation may be submitted in writing or by telephone:

Florida Department of Veteran's Affairs 727-319-7400
P.O. Box 1437
Room 418
St. Petersburg, Florida 33731

MISREPRESENTATION: Intentional misrepresentation of the claim for preference
shall disqualify the applicant from claiming veterans' preference, and if
hired, the employee shall be subject to disciplinary action by the covered
employer.




CS Form 22 (Jul 00)
                     HILLSBOROUGH COUNTY CIVIL SERVICE BOARD
              INSTRUCTIONS FOR COMPLETING THE EMPLOYMENT APPLICATION
       JOB NEWSLINE: (813) 272-6975               JOB FAX LINE: (813) 272-5620
                           WEB SITE: http://www.hccsb.org

            PLEASE READ BEFORE COMPLETING THE EMPLOYMENT APPLICATION

1. It is essential that you fill out your application completely and legibly by answering all questions, not
leaving spaces blank, and by typing or printing clearly, in ink. The information supplied in your application will
be used to help qualify you for the job applied. A poorly completed application may result in your being
declared unqualified. Again, TYPE OR PRINT IN INK ONLY.

2.    When completing the application, use ALL employment history spaces on the basic application form
BEFORE using a continuation form. If you consider a section for employment history to be too small,
continue your comments into the next section. You may also use space in the employment history section to
continue an explanation from any other block, if you believe that information will aid your employment
opportunity.

3. Do not use “NA” or dashes as a response to questions. All questions require “no”, “none” or “yes” with
comments when appropriate.

4. Return your completed application to our office by mail or fax. Our fax number is shown above and our
address is on the front page of the job application.

5. Your qualification for any job for which you apply will be determined by a review of the information you
supply in your application and supporting documents. That information will be compared with the minimum
qualifications reflected in the job bulletin. IF YOU DO NOT MEET THE MINIMUM QUALIFICATIONS OR
YOUR APPLICATION DOES NOT REFLECT YOU MEET THE MINIMUM QUALIFICATIONS, YOU SHOULD
NOT APPLY. The Civil Service Office will not deviate from the minimum qualifications except for those jobs
where substitutions are allowed. Allowable substitutions will be indicated in the bulletin.

6. Qualification of applicants is determined by evaluating applicants' training and experience (T&E) and,
in some cases, by performance and/or written test results. For information, years of experience are
determined based on a forty-hour workweek. Persons who worked less than fulltime (40 hours) will be given
credit for job experience on a pro rata basis; i.e., 10 hours equals one quarter time, 20 hours equals half-
time, 30 hours equals three-quarter time.

7. Former or current military applicants are to indicate EACH major assignment as a separate entry in the
employment history section. Applicants who held more than one job with the same employer are to indicate
each as a separate entry. Each of these jobs must include dates and a description of the duties performed.

8. NO RESUMES OR LETTERS OF RECOMMENDATION will be accepted by Civil Service. You may
however, provide them to the person interviewing you for a position. You are encouraged to be descriptive
and include in your application any information from your resume that might be helpful in qualifying you for
the position applied. Also, DO NOT cut and paste or tape resume or other information to the application
form.

9.   You MUST use Hillsborough County Civil Service Board employment application forms.

10. DOCUMENTATION needed to meet the minimum qualifications (e.g. driver license, "C" certificate,
registration as a professional engineer, official college transcript) must be supplied at time of application.
Failure to submit these when application is made will delay the decision on your qualifications and decrease
your opportunity for employment. Please ensure your social security number is indicated on copies of all
documents you submit with the Application for Employment.



                                                                                                 CSB FORM 23 (01/01)
                     HILLSBOROUGH COUNTY CIVIL SERVICE BOARD
             INSTRUCTIONS FOR COMPLETING THE EMPLOYMENT APPLICATION                                   PAGE 2

11.    YOU MUST LIST on the back of the application the full job title(s) and classification codes you are
applying for in order to be considered. The job titles listed on your application must be under current
recruitment by Civil Service. All open recruitments are posted at the Civil Service Office, or viewed at
http://www.hccsb.org/cs/employment/joblist.html. If the title is not posted, it is not under current
recruitment and application cannot be made. We only accept application when the job title is under
current recruitment!! Application MUST be received in the Civil Service Office by the date and time
indicated in the recruitment bulletin or if mailed, postmarked not later than the recruitment ending date.

12. EXAMINATIONS (if required for qualification) can be administered at the time of application or at a later
date. YOU MUST HAVE A PHOTO I.D. to take an examination. If an examination is required, YOU, as the
applicant, must ensure you are scheduled. Please see the examination hours below.

13. VETERANS PREFERENCE See Civil Service Form 22 for further information. Hillsborough County
does not use a point system to rank order candidates. Accordingly, points are not given. Eligible veterans
are, however, identified as such and are given special consideration in the employment process.

14. Applications are valid for two years from date of receipt. On the expiration of the two year period ALL
applicants making application MUST complete a new one. Therefore, if you are completing a new application
due to outdating of a previous one, YOU MUST ensure the application is updated and all information is
transposed from the old to the new. Your outdated application will be destroyed in accordance with the
schedule established by Florida Statute, and WILL NOT be used to evaluate your qualification for any job you
apply.

15. Applicants certified as qualified for employment will normally be placed on the employment eligibility
list for 90 days. As provided by law, the Civil Service Office reserves the right to cancel entire eligible lists
and to re-open recruitment. In such cases, all applicants on the cancelled list must reapply during the new
recruitment period to be eligible for employment consideration.

16. REMEMBER, you must provide the information to Civil Service to make a fair assessment of your
qualifications for employment. We cannot 'READ BETWEEN THE LINES'. Therefore, please accurately
reflect your qualifications and only apply for the jobs which you know you qualify.

17. If you do not receive information concerning your eligibility from Civil Service within 20 days of the job
closing date (not application date) you should contact us at (813) 272-5628 for a determination of your status.
PLEASE DO NOT CONTACT US BEFORE THEN.

18. Civil Service determines only if you are or are not qualified minimally for the jobs applied. Any decision
to interview or hire is the choice of the hiring agency. Questions relative to the reasons you were or were not
interviewed or hired cannot be answered by Civil Service Board or Staff.

19. If you are hired by any agency serviced by Hillsborough County Civil Service Board, you must present
documentation to substantiate your eligibility for employment and complete an Immigration and Naturalization
Service (INS) Form 9 attesting to employability.

                                             -- OFFICE HOURS --
                                        FOR RECEIVING APPLICATIONS
                                 Monday and Tuesday 7:30 a.m. - 5:00 p.m.
                                 Wednesday                 Closed
                                 Thursday and Friday 7:30 a.m. - 5:00 p.m.

                                FOR TYPING/DATA ENTRY                       FOR WRITTEN
                                        TESTS                                   TESTS
            Monday and Tuesday:   7:30 a.m. - 3:00 p.m.                   7:30 a.m. - 2:00 p.m.
            Wednesday                 Closed                                 Closed
            Thursday and Friday   7:30 a.m. - 3:00 p.m.                  7:30 a.m. - 2:00 p.m.
                                                                                               CSB FORM 23 (01/01)
                       HILLSBOROUGH COUNTY CIVIL SERVICE BOARD
                    FOLLOW-UP EMPLOYMENT APPLICATION
                         Make A Difference – Come Work With Us!

Mailing Address                     Web Site                    Telephone Numbers
P.O. Box 1110                    www.hccsb.org                Staff: (813) 272-5621
Tampa, Florida 33601                                   Job Fax Line: (813) 272-5620

Directions: Only use this form if you previously completed and turned in to our office an
official application form. In that case, fill out the requested information, including your
signature, and mail or fax the form to us.      Please keep in mind that we only accept
applications for jobs which we are currently recruiting for.

If you have not previously completed our official application and submitted it to our Office,
DO NOT USE THIS FORM. Instead, please call us, visit our web site, or email or write to us
at the addresses above to obtain a complete application.


 Social Security Number:


 PRINT Full Name:
                         Last                            First                       Middle

PRINT Mailing Address (Where you want your mail sent)                      Telephone
 Street/Box:                                                      Work: (       )
 City:
 State:                                                           Home: (       )

List the Job Code, Job Title, and Closing Date for each Recruitment you
want to apply for.                                          Closing
       Job Code     Job Title                               Date




On the basis of my application already on file in the Civil Service Office, please consider
me for employment in the following classification(s) which is (are) now on recruitment. I
understand this form must be signed and received in the Civil Service Office not later than
the recruitment ending date (closing date) in order for me to be considered.



                    Signature                                Date


CS Form 1c(11-00)                                                    An Equal Opportunity Employer

								
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