Page 5, Continuation )K!k+J"p ^)k+?9 fields setyellow enterfield enterfield setyellow )K!k+J" ^)k+?9 + _7k+N9 for agency use only + _7k+N9 + _7k+^8 For Agency Use (skill codes, etc.) For Agency Use (skill codes, etc.) Page 2 Page 6 Page 3 Page 4 Page 2 Page 3 page 5 Page 4 About Request " SF 171 Windows, Version 1.1, 12/10/92" &CRLF & Copyright 1992 HTom Murrell" f "OK" Key, isshift, isctrl KeyBack 4pagename temp "SF 171, " & 4startupflag = on "off" 4hautoshift ="on" 4enterpage2flag <> 2 fields 0, 100, 0 -- 4lastfield setyellow 4printflag = "on" = "on" <> "on" "a1" 60,75,100 4pagewidth 4hdisplaypageunits 4xoffset 60, 75.125, 100 -- <>"" 0, 100, 0 -- "daysleft"=0 "Your 30 trial period over. function has been disabled Zyou register." f"OK" "startdate" ="" daysused 3))/60/60/24 4evalflag 30 - 4 > 30 "You have your computer clock Iearlier than installed the program. Lmust reinstall f"OK" "Registered User" Ask "Please type full tname syssuspendmessages Put "This unregisterd may be evaluation H: " & stuff vga resolution 4hMem, lpMem X"user" GetCaretPos ( X"tbkwin.dll" STRING pageFromClient( , INT, HorizontalDisplayRes() " VerticalDisplayRes() linkDLL "kernel" gglobalAlloc( gglobalFree( globalLock( gglobalUnlock( R0,4) 4HDisplayPageUnits 4VDisplayPageUnits 4Hautoshift 4pageheight 4displayflag '= 640 = 350 EGA Video Adapter. was designed use on VGA systems properly on f"OK" = 640 = 480 = 800 = 600 11748 = 1024 = 768 "SF 171, Remove )Reader cHelp e"Open" e"Export" e"Print Report" Pages" e"Printer Setup" e"Run" e"Select hotwords" e"SaveAs" ADD MENU "& e"&Data Form SF 171 Using Preprinted View" e"Set Title Boxes &Gray" &Black" 1 = "yes" 1 = "" e"&Hide Highlights" e"&Show &5 Continuation" Info" Instructions" e"&Quick Tips" c"info" e"&Program Sheet" Menu "Edit" e"&Delete HMenuitem "" e"&Insert New Work Experience" e&Existing c"File" e"&Import counter &" & 8) + 1 "nag screen" B"agree" icon "sf171. Showhighlights < 5 --no buttons on 60, 50, 100 --dark 60, 75.125, 100 -- showhighlights Hidehighlights 0, 100, 0 -- 0, 100, 0 -- hidehighlights buttonyes 4bnameYes ) + 1 bnameNo "B" & buttonno 4bnameno "B" & " X" " X" buttonyes2 ) + 1 "B" & " X" buttonno2 "B" & " X" ExportData tility will data SF171 file ( .EXP) on A drive. Use utility %a means transfer version a future wish d, place a formatted floppy disk Function load f"Yes" "Cancel" SYSTEM FILENAME filename j"SF171VERSION3~" 4firstletter 4maxnumber Firstletter writesub 4lpn2 & "~" 4pcounter exported f"OK" TO HANDLE WRITESUB RSTLETTER MAXNUMBER SET COUNTER TO 1 Openfile tempstring (FIRSTLETTER & pn) & "~" ImportData temp11 containing f"Continue" 4importflag = "SF171Version3" valid does readsub GO TO 4importlastpage imported." f"OK" P-- stop error TEMP9 TO IT syserrornumber = 8011 --PAGE DOESN'T EXIST SEND ADDCONTINUATIONSHEET programhelp "readme.wri" FormInstructions "instruct. QuickTips Right Mouse Button Down Key: Next Previous & "Tab 7Field" & & "Shift k& "If printer cannot on a f"OK" quickTips "SF 171, " & PSetup 480, 360, 360, 360 360, 360 printerPageBitmap To Handle DataForFormSF171UsingPreprintedForm Send AskPages Smargin 0.5 (default 0.35)" f"0.35" > .5 be between 0 0.5" f"OK" * 1440) (.75 * 1440)-( * 1440) 0.5 ( 0.25)" f"0.25" > .5 0.5" f"OK" * 1440) (.5 * 1440)-( * 1440) returnpage agency "blankform" 8) +1 FormSF171AndData sysuspend f"OK" Which want ? (example: 1,2,4 All)" resize sysCaretPosition x&","&y *,sysmagnification,xy) getCaretLoc obj cPos -- unusual = "" yoffset ># = "on" RightBorder BottomBorder caretloc # = "on" ^-750 N minus 750 vert - 1000 - 1000 Page1 pagesub Page2 Page3 Page4 Page5Continuation Page6Continuation Page7Continuation Page8Continuation Page9Continuation "SF 171, " & eleteContinuationSheet delete erase f"OK" "Are $sure its contents???" SYSLOCKSCREEN TO TRUE SYSCURSOR TO 4 LP TO ! &" &LP& ", Clear P TO PAGENUMBER OF THIS GO TO LAST PAGENAME TO PAGESUB BREAK TO GET t" " & & ", "E" INTO TEXT OF FIELD "A" PUT "F" @ "A" N "B" o "A" } "B" GO TO PREVIOUS DECREMENT AddContinuationSheet "Only 5 continuation sheets 5#allowable f"OK" 4newpageflag Pagenumber Last <> "on" create a L &" & (Temp +1) & "?" = "No" Paste &" & ( ++1) &", U% " & ( ++ 1) & ", "SF 171, " & PN TO PN + 1 pn = 6 pn = 7 pn = 8 pn = 9 ("A" & ("B" & UNTIL InsertNewWorkExperience insert a qjob description )A on existing jobs B, B C etc.?" "b16" <> "" pn = 9 "Job be deleted, replaced f"OK" addcontinuationsheet pn + 1 ("A" & ("B" & pn <> 5 ("B" & (pn -1) ("A" & != 17 pn =5 counter2 ("B" & ("A" & ("A" & ("B" & ("A" & Zpn = 4 k,old be available ,final f"OK" eleteExistingWorkExperience "A" & " DeletePage , " & N& ", = "A" p="A <> "A = "B" <> "A H.need either " & & "." f"OK" --marker deletepage 2= "A" ("B" & ("A" & ("A" & ("B" & ("A" & + 1) ("B" & ("B" & %= 17 3= "B" )&= 17 ("A" & ("B" & ("B" & ("A" & <> lpn ("A" & ("B" & ("B" & + 1) ("A" & ("B" & }'= 17 SetTitleBoxesToGray +boxes To "whitetext" 0,87.5,0 -- 0,0,0 m(= 6 .ly" 0,87.5,0 -- /ly" 0,0,0 SetTitleBoxesToBlack 0,0,0 -- 0,100,0 L0ly" 0,0,0 -- z0ly" 0,100,0 D*= 2 a*= ( eadsub Showhighlights programhelp FormInstructions keydown QuickTips Hidehighlights rightbuttonup PSetup DataForFormSF171UsingPreprintedForm leavepage FormSF171AndData AskPages buttonyes keyup buttonno Page1 Page2 About Page3 buttonyes2 Page4 Page5Continuation setyellow Page6Continuation buttonno2 Page7Continuation Page8Continuation enterpage Page9Continuation pagesub ExportData DeleteContinuationSheet WRITESUB AddContinuationSheet leavebook enterBook InsertNewWorkExperience DeleteExistingWorkExperience ImportData SetTitleBoxesToGray readsub SetTitleBoxesToBlack etPosition sysCaretPosition getCaretLoc About SF 171 for Windows, Version 1.1, 12/10/92 Copyright 1992 by Tom Murrell keydown prightbuttonup SF 171, pagename isctrl isshift enterpage enterpage2flag hautoshift startupflag leavepage lastfield fields setyellow xoffset hdisplaypageunits pagewidth hautoshift enterpage2flag printflag lastfield enterBook daysleft Your 30 day trial period is over. The print function has been disabled until you register. seconds startdate startdate startdate daysleft You have set your computer clock back to a date/time earlier than when you installed the program. You must reinstall the program daysleft daysleft Registered User Please type your full name This unregisterd program may be used for a period of 30 days for evaluation by: Registered User GetCaretPos tbkwin.dll pageFromClient HorizontalDisplayRes VerticalDisplayRes kernel globalAlloc globalFree globalLock globalUnlock globalAlloc globalLock HorizontalDisplayRes VerticalDisplayRes hautoshift You are using an EGA Video Adapter. This program was designed for use on VGA systems and may not print properly on your system. hautoshift hautoshift hautoshift SF 171, Page 1 import Export Print Report Print Pages Printer Setup Select all Select Page show hotwords SaveAs &Print &Data for Form SF 171 Using Preprinted Form Print &Form SF 171 and Data Print Printer &Setup Print &View Set Title Boxes to &Gray Set Title Boxes to &Black Set Title Boxes to Gray Set Title Boxes to Black &Hide Highlights &Show Highlights Show Highlights Page &1 Page &2 Page &3 Page &4 Page &5 Continuation Page 1 &Info &Form Instructions &Quick Tips &Program Help &About Add Con&tinuation Sheet &Delete Continuation Sheet &Insert New Work Experience Delete &Existing Work Experience &Export Data &Import Data Add Continuation Sheet Delete Continuation Sheet Insert New Work Experience Delete Existing Work Experience Page & , Continuation Page 1 nag screen agree sf171.ico startupflag pagename counter displayflag pageheight pagewidth Hautoshift VDisplayPageUnits HDisplayPageUnits lpMem tname evalflag daysused Showhighlights Show Highlights Hide Highlights buttons counter Hidehighlights Hide Highlights Show Highlights buttons fields counter buttonyes bnameNo bnameYes buttonno bnameNo bnameNo bnameNo bnameYes bnameno buttonyes2 bnameNo bnameYes buttonno2 bnameNo bnameNo bnameNo bnameYes bnameno ExportData This utility will save the data from this SF171 to a text file (SF171.EXP) on your A drive. Use this utility to back up your data or as a means to transfer data from this version of the program to a future version of the program. If you wish to continue, place a formatted floppy disk into your A drive. Use the Import Function to load data into form. Cancel filename a:\sf171.exp filename SF171VERSION3~ filename filename Firstletter writesub Firstletter writesub Firstletter writesub Firstletter writesub Firstletter writesub Firstletter writesub Firstletter writesub Firstletter writesub filename filename filename Firstletter writesub Firstletter writesub Firstletter writesub The data from this SF171 form has been exported to your A drive. pcounter maxnumber firstletter FILENAME WRITESUB filename counter counter maxnumber filename filename tempstring COUNTER MAXNUMBER FIRSTLETTER FILENAME ImportData This utility will import data from your A drive. Insert the floppy disk containing the data file (SF171.EXP) into your A drive. Continue Cancel Continue cancel filename a:\sf171.exp filename filename SF171Version3 This disk does not contain the proper file filename Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub filename Firstletter 5readsub Firstletter 5readsub Firstletter 5readsub The data from this SF171 form has been imported. filename pcounter importlastpage maxnumber firstletter FILENAME importflag temp11 readsub filename firstletter counter ADDCONTINUATIONSHEET firstletter counter counter counter maxnumber pagename TEMP9 COUNTER MAXNUMBER FIRSTLETTER FILENAME programhelp readme.wri FormInstructions instruct.wri QuickTips Right Mouse Button or Page Down Key: Next Page Page Up Key: Previous Page Tab Key: Next Field Shift and Tab Key: Previous Field If your printer cannot print white text on a black background, set Title Boxes to Gray in the View Menu rightbuttonup SF 171, pagename PSetup DataForFormSF171UsingPreprintedForm _AskPages 'PSetup Set the left margin in inches, from 0 to 0.5 (default is 0.35) cancel the margin must be between 0 and 0.5 Set the top margin in inches, from 0 to 0.5 (default is 0.25) cancel the top margin must be between 0 and 0.5 ahidehighlights for agency use only for agency use only blankform page 1 blankform page 2 blankform page 3 blankform page 4 blankform page 5 ahidehighlights for agency use only for agency use only blankform page 1 blankform page 2 blankform page 3 blankform page 4 blankform page 5 showhighlights counter returnpage printpages FormSF171AndData _AskPages 'PSetup ahidehighlights ahidehighlights showhighlights sysuspend counter printpages returnpage AskPages The print function is disabled after 30 days of evaluation Which Page(s) do you want to print? (example: 1,2,4 or All) cancel printpages evalflag sysCaretPosition GetCaretPos pageFromClient lpMem getCaretLoc sysCaretPosition textfrompoint keyup field sysCaretPosition lastfield caretloc BottomBorder RightBorder yoffset xoffset pageheight pagewidth VDisplayPageUnits HDisplayPageUnits displayflag hautoshift Page1 5pagesub Page2 5pagesub Page3 5pagesub Page4 5pagesub Page5Continuation 5pagesub Page6Continuation 5pagesub Page7Continuation 5pagesub Page8Continuation 5pagesub Page9Continuation 5pagesub pagesub SF 171, pagename DeleteContinuationSheet You cannot delete Page 5. If you want to erase the data, use from the Edit Menu. Are you sure you want to delete page and all of its contents??? Page & , Continuation Clear COUNTER PAGENAME 5PAGESUB Page , Continuation COUNTER COUNTER COUNTER COUNTER COUNTER 5pagesub pagename counter AddContinuationSheet Only 5 continuation sheets are allowable with this version of the program Do you wish to create a continuation sheet, Page & cancel Paste Page & , Continuation Page , Continuation SF 171, COUNTER pagename importflag newpageflag leavebook kernel tbkwin.dll globalUnlock globalFree lpMem InsertNewWorkExperience Do you wish to insert a new job description at A on page 2, and shift existing jobs from A to B, B to C etc.? Job description L will be deleted, and replaced by job description K addcontinuationsheet This function will allow you to delete an existing job description and shift the old jobs up. This function will be available in the final version of the program. counter2 counter DeleteExistingWorkExperience A or B Which job description, , do you wish to delete? A or B A or B A or B A or B You need to select either deletepage deletepage counter2 counter DeletePage SetTitleBoxesToGray Set Title Boxes To Gray Set Title boxes To Black whitetext page whitetext page for agency use only page for agency use only page counter SetTitleBoxesToBlack Set Title Boxes To Gray Set Title boxes To Black whitetext page whitetext page for agency use only page for agency use only page counter :PRINTLAYOUT Arial System Arial Arial Arial Arial mes New Roman Arial Arial Arial Arial Arial Arial Times New Roman Arial 171, Page 4 uation 171, Page 4 uation mes New Roman Arial Arial Arial Times New Roman Wingdings Arial Times New Roman Arial Arial , Page 4 Times New Roman ;H-@; Arial Times New Roman Times New Roman Wingdings Times New Roman 171, Page 4 uyQsDAmx mes New Roman Times New Roman 171, Page 4 171, Page 1 uation Arial Arial Arial Arial Arial Times New Roman Times New Roman Arial Arial 171, Page 1 uation Arial Arial Arial 171, Page 4 171, Page 1 171, Page 4 171, Page 2 Times New Roman System SF 171, Page 1 Page 1 (#44t O8L6e "B ~$ tL/(C 'V"HNy) y)V"nN V"J+V" ~'Y+~' }(Y+}( "}(\Q %E!p&(R3$ .,h+J. ]9;+]9 $Y=f- N96cp (g~$] $2hJ+ J+e"XhO blankform Application for Federal Employment -- SF 171 What kind of job are you applying for? Give Title and announcement no. (if any) Standard Form 171 (Rev. 6-88) U.S. Office of Personnel Management FPM Chapter 295 NSN 7540-00-935-7150 171-11000 List the dates (Month, Day, Year), and branch for all active duty military service. When can you start work? (Month and Year) What is the lowest pay you will accept? (You will not be considered for jobs which pay less than you indicate) Female Were you discharged from the military service under honorable conditions? (If your discharge was changed to"honorable" or "general" by a Discharge Review Board, answer "YES". If you received a clemency discharge, answer " NO".) If "NO", provide below the date and type of discharge you received. Discharge Date (Month, Day, Year) Being Investigated A. 40 hours per week (full-time)?. . . . . . . . . . . . . . . . . . . . . . . . . .k (on-call/seasonal)? . . . . . . E. er hours per week (on-call/seasonal)? . . . . . . E. er hours per week (on-call/seasonal)? . . . . . . E. nal)? . . . . . . E. nal)? . . . . . . E. seasonal)? . . . . . . E. B. 25-32 hours per week (part-time)? . . . . . . . . . . . . . . . . . . . . . . C. 17-24 hours per week (part-time)? . . . . . . . . . . . . . . . . . . . . . . . . D. 16 or fewer hours per week (part-time)? . . . . . . . . . . . . . . . . E. An intermittent job (on-call/seasonal)? . . . . . . . . . . . . . . . . F. Weekends, shifts, or rotating shifts? . . . . . . . . . . . . . . . . . . . . C. 11 or more nights each month? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Were you ever employed as a civilian by the Federal Government? If "NO", go to Item 11. If "YES", mark each type of job you held with an "X". Social Security Number Birth date (Month, Day, Year) Birthplace (City and State or County) Name (Last, First, Middle) Mailing Address (include apartment number, if any) State ZIP Code Other names ever used (e.g., maiden name, nickname, etc.) Home Phone Work Phone Area Code Number Area Code Number Extension Temporary Career-Conditional Career Excepted What is your highest grade, classification series and job title?? In what geographic area(s) are you willing to work? Are you willing to work: Are you willing to take a temporary job lasting: A. 5 to 12 months (sometimes longer)? . . . . . . . . . . . . . . . . . . B. 1 to 4 months? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... C. Less than 1 month? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Are you willing to travel away from home for:ng: A. 1 to 5 nights each month?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. 6 to 10 nights each month? . . . . . . . . . . . . . . . . . . . . . . . . . . . ......................... Have you served in the United States Military Service? If your only active duty was training in the Reserves or National Guard, answer "NO". If "NO", go to item 22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Did you or will you retire at or above the rank of major or lieuten- ant commander? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. FOR USE OF EXAMINING OFFICE ONLYc@ FOR USE OF APPOINTING OFFICE ONLY Date entered register Form reviewed: Form approved: Option Grade Earned Rating Veteran Preference Augmented Rating "B ~$ Preference Claimed 5 Points (Tentative) 10 Pts. (30% Or More Comp. Dis.) 10 Pts. (Less Than 30% Comp. Dis) Other 10 Points Disallowed Initials and Date Preference has heen verified through proof that the separation was under honorable conditions, and other proof as required. 5-Point 10-Point--30% or More Compensable Disability 10-Point--Less Than 30% Compensable Disability 10-Point--Other Signature and Title Agency V"J+V" Type of Discharge ~'Y+~' }(Y+}( %E!p& Branch of Service If all your active military duty was after October 14, 1976, list the full names and dates of campaign badges or expeditionary medals you received or were entitled to receive..... .,h+J. Read the instructions that came with this form before completing this item. When you have determined your eligibility for veteran preference from the instructions, place an "X" in the box next to your veteran preference claim.. NO PREFERENCE 5-POINT PREFERENCE -- You must show proof when you are hired. 10-POINT PREFERENCE -- If you claim 10-point preference, place an "X" in the box below next to the basis for your claim. To receive 10-point preference you must also complete a Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center. ATTACH THE COMPLETED SF 15 AND REQUESTED PROOF TO THIS APPLICATION. Non-compensably disabled or Purple Heart recipient. Compensably disabled, less than 30 percent.cipient. Spouse, widow(er), or mother of a deceased or disabled veteran. Compensably disabled, 30 percent or more.recipient. THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER PREVIOUS EDITION USABLE UNTIL 12-31-90 ]9;+]9 Page1 PREVIOUS EDITION USABLE UNTIL 12-31-90 U.S. Office of Personnel Management FPM Chapter 29555l Management FPM Chapter 295 $Y=f- FPM Chapter 29571 (Rev. 6-88) U.S. Office of Personnel Management FPM Chapter 295 Dates at highest grade: FROM TOOOOOOOOOOOO TOtes at highest grade: FROM TOOOOOOOOOOOO OR Grade per OR Grade OR Grade Pay $ per OR Grade Form Approved OMB No. 3206-0012 DO NOT WRITE IN THIS AREA whitetext GENERAL INFORMATION AVAILABILITY MILITARY SERVICE AND VETERAN PREFERENCE (Cont.) MILITARY SERVICE AND VETERAN PREFERENCE FPM Chapter 295 Read the instructions before you complete this application. Type or print clearly in dark ink. Page 1 '9!O)G" )9!/+G" buttons 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes buttonup buttonup buttonup buttonup buttonup buttonup buttonup buttonup buttonup buttonup buttonup buttonup "b38" "b39" "b40" "b41" "b42" buttonup buttonup "b37" "b39" "b40" "b41" "b42" buttonup buttonup "b37" "b38" "b40" "b42" Request "A Standard Form 15, Application 10-Point Veteran Preference, which available Federal Job Information Center must be attached." f"OK" buttonup buttonup A Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center must be attached. "b37" "b38" "b39" "b42" Request "A Standard Form 15, Application 10-Point Veteran Preference, which available Federal Job Information Center must be attached." f"OK" buttonup buttonup A Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center must be attached. 8 Ib* "b37" "b38" Request "A Standard Form 15, Application 10-Point Veteran Preference, which available Federal Job Information Center must be attached." f"OK" buttonup buttonup A Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center must be attached. "b37" "b38" "b39" "b40" Request "A Standard Form 15, Application 10-Point Veteran Preference, which available Federal Job Information Center must be attached." f"OK" buttonup buttonup A Standard Form 15, Application for 10-Point Veteran Preference, which is available from any Federal Job Information Center must be attached. '9!O)G" 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes )9!/+G" 4bnameno buttonno buttonup buttonup buttonno bnameno o'TAj n(&Bj "n(lB fields setyellow enterfield enterfield setyellow startdate nag screen SF 171 For Windows Version 1.10000000 Copyright (C) 1992 by Finish Line Software All rights reserved. This is an unregistered version of the program that may be used for evaluation for a period of 30 days. Agree "nag screen" buttonup buttonup nag screen I Agree To Terms of Use Registered User To register, and receive the latest version of the program, send $20.00 to: Tom Murrell 17106 Laoana Eagle River, Alaska 99577 ncidental, consequential, or similar damages) claimed by you or any other person or entity as a result of the use of this program. This includes rejection of a job application, loss of job opportunities, time, money, data or other resources. daysleft Evaluation Days Remaining Page 2 e"Insert New Work Experience" e"Delete Existing ackground enterbackground leavebackground enterbackground Insert New Work Experience Delete Existing Work Experience leavebackground Insert New Work Experience Delete Existing Work Experience >+` J '$ +'$ 8"b% E$|)&% #^4%&G" ^)M+^) 63 `'3 O) ^)&7k 8Q B' ~' +A(0: 9 + : #,@8( blankform May we ask your present employer about your character, qualifications, and work record? A "NO" will not affect our review of your qualifications. If you answer "NO" and we need to contact your present employer before we can offer you a job, we will contact you first. . . . . . . . . . . . . . . . . . . . . . . READ WORK EXPERIENCE IN THE INSTRUCTIONS BEFORE YOU BEGIN. Describe your current or most recent job in Block A and work backwards, describing each job you held during the past 10 years. If you were unemployed for longer than 3 months within the past 10 years, list the dates and your address(es) in an experience block. You may sum up in one block work that you did more than 10 years ago. But if that work is related to the type of job you are applying for, describe each related job in a separate block. INCLUDE VOLUNTEER WORK (non-paid work)--If the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations. You may sum up in one block work that you did more than 10 years ago. But if that work is related to the type of job you are applying for, describe each related job in a separate block. INCLUDE VOLUNTEER WORK (non-paid work)--If the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations...the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations. INCLUDE VOLUNTEER WORK (non-paid work)--If the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations.plete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations...the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations. INCLUDE MILITARY SERVICE--You should complete all parts of the experience block just as you would for a non-military job, including all supervisory experience. Describe each major change of duties or responsibilities in a separate experience block.ience block. You may sum up in one block work that you did more than 10 years ago. But if that work is related to the type of job you are applying for, describe each related job in a separate block. INCLUDE VOLUNTEER WORK (non-paid work)--If the work (or a part of the work) is like the job you are applying for, complete all parts of the experience block just at you would for a paying job. You may receive credit for work experience with religious, community, welfare, service, and other organizations. IF YOU NEED MORE SPACE TO DESCRIBE A JOB--Use sheets of paper the same size as this page (be sure to include all information we ask for in A and B below). On each sheet show your name, Social Security Number, and the announcement number or job title.... IF YOU NEED MORE EXPERIENCE BLOCKS use the SF 171-A or a sheet of paper..ze as this page (be sure to include all information we as for in A and B below). On each sheet show your name, Social Security Number, and the announcement number or job title..... IF YOU NEED TO UPDATE (ADD MORE RECENT JOBS), use the SF 172 or a sheet of paper as described above. include all information we as for in A and B below). On each sheet show your name, Social Security Number, and the announcement number or job title..... Ending $$ From: Name and address of employer's organization (include ZIP Code, if known) Dates employed (give month, day and year) Average Number of hours per weekS% Salary or earnings Starting $ Your reason for wanting to leave hours per week you supervised Number of employees Description of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work (for example, carpentry and painting, or personnel and budget), write the approximate percentage of time you spent doing each. Your immediate supervisor Area Codesssssssss Telephone No. Exact title of your job rank, and if promoted in this job, date of your last promotion rank, and, if promoted in this job the date of your last promotionn Ending $$ From: Name and address of employer's organization (include ZIP Code, if known) '$ +'$ ~161{1 Dates employed (give month, day and year) 8"b% Average Number of hours per week-2 Salary or earnings Starting $ E$|)&% Your reason for leaving to leave hours per week you supervised Number of employees Description of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work (for example, carpentry and painting, or personnel and budget), write the approximate percentage of time you spent doing each. ^)M+^) 3 `'3 O) Your immediate supervisor Area Codesssssssss Telephone No. Exact title of your job ~' +A( rank, and if promoted in this job, date of your last promotion rank, and, if promoted in this job the date of your last promotionn If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job the date of your last promotionn If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job the date of your last promotionn Page 2 9 + : IF YOU NEED MORE EXPERIENCE BLOCKS, USE SF 171-A (SEE BACK OF INSTRUCTION PAGE). whitetext WORK EXPERIENCE If you have no work experience, write "NONE" in A below and go to 25 on page 3. Page 2 buttons 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno S(k+R) fields setyellow enterfield enterfield setyellow S(k+R) + k+ + k+ + \+ for agency use only For Agency Use (skill codes, etc.) + \+ + \+*! For Agency Use (skill codes, etc.) Page 1 Page 3 ` D%` ~'r4} *48'$ 0`.c. ZIP Code Do you receive, or have you ever applied for retirement pay, pension, or other pay based on military, Federal civilian, or District of Columbia Government service? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '4&z+4& !k+4& Do any of your relatives work for the United States Government or the United States Armed Forces? Include: father; mother; husband; wife; son; daughter; brother; sister; uncle; aunt; first cousin; nephew; niece; father-in-law; mother-in-law; son-in-law; daughter-in-law; brother-in-law; sister-in-law; stepfather; stepmother; stepson; stepdaughter; stepbrother; stepsister; half brother; and half sister. . . . . . . . . . . . . . . . . . . . . . . . . . . . . If "YES", provide details below. If you need more space, use a sheet of paper. V6.6S6 Relationship Department, Agency or Branch of Armed Forces {*z+{* n7z+n7 SIGNATURE (sign each application in dark ink) DATE SIGNED (Month, day, year) YOU MUST SIGN THIS APPLICATION. Read the following carefully before you sign. l A false statement on any part of this application may be grounds for not hiring you, or for firing you after you begin work. Also, you may be punished by fine or imprisonment (U.S. Code, title 18, section 1001)...................... section 1001). l If you are a male born after December 31, 1959 you must be registered with the Selective Service System or have a valid exemption in order to be eligible for Federal employment. You will be required to certify as to your status at the time of appointment... H? >E? l I understand that any information I give may be investigated as allowed by law or Presidential order.em or hafe a valid exemption in order to be elegble for Federal employment. You will be required to certify as to your status at the time of appointment. q4k+`6 l I consent to the release of information about my ability and fitness for Federal employment by employers, schools, law enforcement agencies and other individuals and organizations,to investigators, personnel staffing specialists, and other authorized employees of the Federal Government.. Page 4 whitetext BACKGROUND INFORMATION--You must answer each question in this section before we can process your application. SIGNATURE, CERTIFICATION, AND RELEASE OF INFORMATION his section before we can process your application. Page 4 'D%|) )D%\+ buttons 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes 4bnameno buttonno buttonup buttonup buttonno bnameno 'D%|) 4bnameyes bnameYes buttonyes buttonup buttonup bnameYes buttonyes bnameyes )D%\+ 4bnameno buttonno buttonup buttonup buttonno bnameno z+x!Z fields setyellow enterfield enterfield setyellow Page 1 Page 5, Continuation page 5 "F5" 1 <> "" "f1" = "" "F5" "F2" 1 <> "" "F2" = "" "F2" "F1" 1 <> "" "F3" = "" "f1" "f25" 4 <> "" "f4" = "" e"Add Continuation Sheet" e"Delete Existing Work Experience" terpage enterbackground enterpage leavebackground enterpage enterbackground Add Continuation Sheet Delete Continuation Sheet Delete Existing Work Experience leavebackground Add Continuation Sheet Delete Continuation Sheet Delete Existing Work Experience e"k+e"j C&X C&e" >+9!\ 9k+z: ` M+` v!%&S blankform Ending $$ l Attach all SF 171-A's to your application at the top of page 3.. 1. Name (Last, First, Middle Initial) 3. Job Title or Announcement Number You Are Applying For 2. Social Security Number 4. Date Completed Form Approved OMB No. 3206-0012G From: Name and address of employer's organization (include ZIP Code, if known) e"k+e" C&X C&e" Dates employed (give month, day and year) Average Number of hours per week Salary or earnings Starting $ Your reason for leaving to leave] hours per week you supervised >+9! Number of employees Description of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work (for example, carpentry and painting, or personnel and budget), write the approximate percentage of time you spent doing each. Your immediate supervisor Area Codesssssssss Telephone No. Exact title of your job If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job the date of your last promotionn THE FEDERAL GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER PREVIOUS EDITION USABLE PREVIOUS EDITION USABLE 9k+z: Standard Form 171-A (Rev. 6-88) U.S. Office of Personnel Management FPM Chapter 295 rank, and if promoted in this job, date of your last promotion rank, and, if promoted in this job the date of your last promotionn Ending $$ From: Name and address of employer's organization (include ZIP Code, if known) ` M+` Dates employed (give month, day and year) Average Number of hours per week Salary or earnings Starting $ Your reason for leavinggeeeeeeei$ hours per week you supervised Number of employees Description of work: Describe your specific duties, responsibilities and accomplishments in this job, including the job title(s) of any employees you supervise. If you describe more than one type of work (for example, carpentry and painting, or personnel and budget), write the approximate percentage of time you spent doing each. Your immediate supervisor Area Codesssssssss Telephone No. Exact title of your job If Federal employment (civilian or military) list series, grade or rank, and, if promoted in this job the date of your last promotionn rank, and if promoted in this job, date of your last promotion rank, and, if promoted in this job the date of your last promotionn U.S. Office of Personnel Management FPM Chapter 295 el Management FPM Chapter 295 Continuation Sheet for SF 171ation Sheet for SF 1711 Standard Form 171-A-- whitetext whitetext ADDITIONAL WORK EXPERIENCE BLOCKS sf171.ico wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwq wwwwwww wwwwwwwwp wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww wwwwwwwww