Section 2 Applicant Data
Print or Type
*First Name M.I. *Last Name
*Address line 1 Address line 2
*City *State *Zip
( ) ( )
*Phone (area code) Home phone Phone (area code) Work phone Other phone (i.e., mobile)
Contact e-mail address Fax Web address
Fields with * are required
JOB TITLES (see instructions on page 1) Job Vacancy Number*
*An accurate job vacancy number is required to process your application.
Preferred Method of Contact: E-mail U.S. Postal Service
Are you a permanent State of Iowa employee? Yes No
If Yes, please check one:
Executive Branch Regents Community Based Corrections Judicial Branch Legislative Branch
What Executive Branch Department do you work for?
Circle highest year of education completed
1 2 3 4 5 6 7 8 9 10 11 12 High School graduate or equivalent (GED)? ¨ Yes ¨ No
Dates Attended Credit Received Field of Study or Area of Concentration
Name and Location of Schools
Attended Beyond High School
Major Hours Minor Hours
If you are working toward a degree, please give the anticipated completion date: Do not send a transcript unless requested.
GUIDELINES FOR ACCEPTING TYPING TEST SCORES ARE AS FOLLOW:
We accept typing scores from the following sources: Iowa Workforce Development Offices, high schools, temporary employment
offices (e.g., Olsten or Kelly), private companies or area community colleges. The criteria for accepting scores from these sources are:
1) Typing scores must be submitted on official letterhead of the company or school.
2) Scores must be signed and dated within the last six months by a teacher, test administrator or human resource official.
3) Information required.
a) Gross number of words typed in a five minute timed test.
b) Number of errors.
c) Net words per minute (one point deduction for each error).
4) Applicant name and social security number.
Most Workforce Centers are willing to fax the results upon request. Our fax number is (515) 281-7970.