Fillable Printable State of Florida Employment Application

State of Florida Employment Application

• Completeallinformationwithinthisapplicationinitsentirety.

• Typeorprintinink.

• Allinformationprovidedwillbeapublicrecordandwillbereleasedupon

request,unlessexemptorcondential.

• Specifythepositionforwhichyouareapplying.(Note:Aseparate

applicationmustbesubmittedforeachvacancy.Photocopiesare

acceptable.)

• SubmitapplicationtothePeopleFirstServiceCenter,

FAX:904/636-2627,nolaterthan11:59PM(EST)ontheannounced

deadlinedate.

• SignyournameintheCerticationSection(page4).Allinformationyou

submitissubjecttoverication.

Where to Find Vacancy Information:

• OntheInternet:https://peoplerst.myorida.com

• OneStopCareerCenters - Consult your local telephone directory or visit

http://www.employorida.com

• StateAgencyPersonnelOfces

POSITION APPLIED FOR

FOR OFFICIAL USE ONLY

 AgencyAuthorizedSignature Date Broadband/ClassCode Status

Agency:___________________________________________________________________________

Title:______________________________________________________________________________

PositionNumber:___________________________ DateAvailable:____________________________

CountiesofInterest: _________________________________________________________________

MinimumAcceptableSalary: __________________________________________________________

EDUCATION

YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL:________________________________________________________________________________________________________________ 

HIGHSCHOOL:

NAME/LOCATIONOFSCHOOL rECEIVED:

Diploma



Other(specify)



None

LICENSE,rEGISTrATIONOrCErTIFICATION: Number Datereceived ExpirationDate StateLicensingAgency

HOW DO WE CONTACT YOU?

YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL: ________________________________________________________________________________________________________________

GENERAL INSTRUCTIONS FOR COmPLETION OF APPLICATION:

YOUrNAME,IFDIFFErENTWHILEATTENDINGSCHOOL: ________________________________________________________________________________________________________________

LICENSUrE,rEGISTrATION,CErTIFICATION

(EXAMPLES:TeacherCertication,rN,LPN,PE,CPA,etc.)

EqualOpportunityEmployer/AfrmativeActionEmployer

TheStateofFloridadoesnottolerateviolenceintheworkplace.

JOB-rELATEDTrAININGOrCOUrSEWOrK:(VOCATIONAL,TrADE,GOVErNMENTAL,BUSINESS,ArMEDFOrCES,ETC.)

StateofFlorida

EMPLOYMENT

APPLICATION

Name   

PeopleFirstEmployeeIDNumber(ifany)

MailingAddress

City County StateZipCode

Phone AlternatePhone

 

E-mailAddress

FrOM

TO YES NOCLOCK

CLASS

DATESOF

ATTENDANCE

(MONTH/YEAr)

CrEDIT

HOUrS

EArNED

COUrSEOF

STUDY

TrAINING

COMPLETED

NAMEOFSCHOOL

LOCATION

COLLEGE,UNIVErSITYOrPrOFESSIONALSCHOOL:(TrANSCrIPTSMAYBErEqUIrED)

    DATESOF   CrEDIT  MAJOr/MINOr TYPEOF

   ATTENDANCE  HOUrS  COUrSEOF DEGrEE

 NAMEOFSCHOOL LOCATION (MONTH/YEAr)  EArNED  STUDY EArNED

   FrOM  TO qTr  SEM

NameofPresentorLastEmployer:_____________________________________________________________________________________________________

 Address: ____________________________________________________________________________ YourJobTitle: ____________________________________ 

 Supervisor’sName:_____________________________________________________________PhoneNo.:(_____) ________________________

 FrOM:_____/_____/_____TO:_____/_____/_____HOUrSPErWEEK:_______(_________________________)



Dutiesandresponsibilities: ______________________________________________________________________________________________________________

 _____________________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________

reasonForLeaving: ____________________________________________________________________________________________________________________

PErIODSOFEMPLOYMENT

Describeallworkexperienceindetail,beginningwithyourcurrentormostrecentjob.Includemilitaryservice(indicaterank),internshipsandjob-relatedvolunteerwork,ifapplicable.Indicatenumber

ofemployeessupervised.Useaseparateblocktodescribeeachpositionorgapinemployment.Ifneeded,attachadditionalsheets,usingthesameformatasontheapplication.Allinformationinthis

sectionmustbecompleted.resumesmaybeattachedtoprovideadditionalinformation.

MONTH DAY YEAr

YOUrNAMEIFDIFFErENTDUrINGEMPLOYMENT

NameofNextPreviousEmployer:______________________________________________________________________________________________________