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VA DHRM Form 10-012 1999 free printable template

Commonwealth of Virginia DPT Form 10-012 Rev. 10/99 Please print in ink preferably black or use typewriter Number of attachments Position number Application for Employment Employees of the Commonwealth and applicants for employment shall be afforded equal opportunity in all aspects of employment without regard to race color religion political affiliation national origin disability marital status gender or age.
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Please enclose a current resume, a brief letter of interest describing the nature of employment for which you are applying, and contact information for two professional references. Application for Employment Address: Department of Administrative Services Office of Information Technology and Mass Technology Applications, Attn: Virginia Application Process Deadline: 2/18/2018 Application Fee: Apply online to apply or download and print the application form. If hiring, a non-refundable 50 application fee will be deducted automatically from your final check. Submit your application to the Virginia Employment Commission online or print and mail this form to: Virginia Employment Commission, PO Box 3048, Richmond, VA 23 The Virginia Employment Commission is the Equal Opportunity Employer Commission under Title V of the Civil Rights Act of 1964 and the Equal Pay Act of 1963.

Who needs the DRM Form 10-012?

Any person applying for employment in the Commonwealth of Virginia needs this form.

What is the purpose of the DRM Form 10-012?

The DRM Form 10-012 is an application for employment.

What documents should accompany the DRM Form 10-012?

The agency announcing the vacancy may request the applicant to provide other documents along with the form.

What information should be provided?

The applicant provides the following information: position applied for; agency; SSN; full legal name; address; home and business phones; e-mail address.

In section 9 “Education”, the applicant should indicate the highest grade he completed; number of years of post high school education; name and location of institution; degree received; specialty or major; minor; dates attended.

Section 10 “Experience” contains the following entries: job title; employer; type of business; immediate supervisor; title; salary; duties; number and titles of employees under the applicant’s supervision; equipment used; reasons for leaving; additional information including training, seminars, workshops, achievements; special skills; automation word processing; typing speed; shorthand speed; licenses, certificates or other authorization to practice a profession or trade.

In section 11 “References”, the applicant should provide names, addresses, and relationships or three persons not related to the applicant who know the applicant’s qualifications.

Section 12 “Miscellaneous” contains the following entries: (a) acceptable shifts (day, evening, night, rotating, weekends); (b) job status (full-time or part-time); (c) employment status (salaried, hourly, part-time salaried); (d) possibility to travel; list of the geographic locations where the applicant is willing to work; willingness to provide transportation; question about US employment legality; question about registration for the Selective Service; question about convictions for violations of law; date when the applicant would be available to start work.

In section 14 the applicant certifies that all entries are true and complete and that he understands and agrees that any falsification may cause forfeiture of any employment in the service of the Commonwealth of Virginia.

The applicant dates and signs the DRM Form 10-012.

Finally, the applicant indicates the racial and ethnic group he belongs to; the highest level of education the applicant completed; and gender.

Where do I send the DRM Form 10-012?

The applicant should send this form directly to the agency announcing the vacancy.


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