Enter your Social Security Number in the space indicated. Providing your Social Security Number is voluntary, however we can not process your application without it.
The Vacancy Identification Number is: 636339
Safety and Occupational Health Specialist
All biographic information is required, except for your telephone number and the contact time.
Enter the lowest grade level (07-07) you will accept.
Select your claim for Veterans' Preference.
These dates are required if you have claimed Veterans' Preference unless you have claimed derived Preference (i.e., widows, spouse, etc.)
Please use this format: (mm/dd/yyyy)
You may omit the availability date if you can begin work immediately. Otherwise you must provide the date you will be available for employment. Please use this format: (mm/dd/yyyy)
Select/enter at least one occupational specialty. The specialty code for this position is:
Select/enter at least one geographic location in which you are interested and will accept employment. The location code for this position is:
In this section indicate if you are a surplus or displaced Federal employee requesting special priority consideration under the Career Transition Assistance Plan (CTAP) or the Interagency Career Transition Assistance Plan (ICTAP).
Note: To receive consideration for CTAP or ICTAP, you must submit the necessary supporting documentation. Refer to the vacancy announcement for additional information and instructions.
Please insert the total number of years and months of your job related experience.
The United States District Court for the District of Columbia, in a decree approved in a lawsuit entitled Luevano v. Lachance, Civil Action no. 79-0271, has ordered that Federal Government agencies provide data on the race and national origin of applicants for certain Federal occupations. The position for which you are applying is in one of those occupations. The collection of this information is authorized for use by the Office of Personnel Management only for the purposes of complying with the requirements of the Luevano v. Lachance Decree. The data you supply will be used for statistical analysis pursuant to the requirements of the lawsuit, and will not be shared with employing agencies. You are requested to complete the following, however, submission of this information is voluntary. Your failure to do so will have no effect on the processing of your application for Federal employment.
The categories ( items 1-6 ) below provide descriptions of race and national origins. Select the category with which you identify yourself. If you are of mixed race and/or national origin, select the category with which you most closely identify yourself. Please select only one by shading in the circle next to the number corresponding to the category.
PRIMARY GEOGRAPHIC ZONE
Select the Zone ( items 7-15 ) which includes your first choice for location of employment. This designation is for statistical use only and will not affect your actual consideration for employment. Your geographic area of consideration will be determined by your entries in Section 21, GEOGRAPHIC AVAILABILITY. Please select only one or darken the appropriate circle next to the number corresponding to your selection.
EDUCATIONAL BACKGROUND AND WORK EXPERIENCE
This section asks you to describe your educational background, your work, and other experiences in specific factors which relate to job performance. ALL QUESTIONS MUST BE ANSWERED. Record your answers in Section 25.
1. Please select "A" for this question. DO NOT LEAVE THIS QUESTION BLANK.
2. From the descriptions below, select the letter that describes the education or experience you have that demonstrates your ability to perform GS-7, Safety and Occupational Health work. If your highest level of education is not described below, choose the letter that describes experience or lower level education that you do have. Mark only 1 response.
3. Please fill in "A" for this question.
4. Please fill in "A" for this question.
5. Please fill in "A" for this question.
The following questions ask you to describe your educational background, your work, and other experiences in specific areas which relate to successful job performance.
You are to choose one answer to each question from among the alternatives presented. Then, record your answers in Section 25 on OPM Form 1203 FX (Form C) beginning at Item 6. Do not mark more than one answer for each question. Multiple answers will not be counted. Do not omit answers unless instructed to do so. Other omissions may decrease your score.
1. During high school (grades 9 - 12), I made the semester honor roll:
2. The high school grade I most often received was:
IF YOU DID NOT ATTEND COLLEGE, PLEASE SKIP TO ITEM 4.
3. The college grade I most often received was:
4. In the past three years the number of different paying jobs I have held for more than two weeks is:
5. I have been employed in work similar to that of the job covered by this examination:
6. In the past three years, my primary work experience has been in:
7. On my present or most recent job, my supervisor rated me as:
8. In the past three years the number of jobs I have been fired from is:
9. The number of civic or social organizations (which have regular meetings and a defined membership) that I belong to is:
10. In organizations to which I belong, my participation is best described as:
11. My previous supervisors (or teachers if not previously employed) would most likely describe my basic math skills as:
The questions in this part relate to fundamental competencies, such as problem solving and oral communication, required for the job for which you are applying.
Please answer each question "A" for YES or "B" for NO.
Keep in mind the following:
1) Some questions refer to "work" experience. Unless otherwise stated, this includes experience you have gained through:
· Volunteer work,
· Military service,
· Paid employment,
· Hobbies, or
· Professional, charitable, religious, community, social, or other organizations.
12. Have you successfully done work that regularly involved composing letters or writing reports containing several short paragraphs, such as investigation reports, accident reports, performance evaluations, etc.?
13. Have you received formal recognition for solving a work-related problem (for example, received an award, a letter of commendation, etc.)?
14. Have you received formal recognition for your written work (for example, received an award, letter of commendation, excellent performance appraisal rating, etc.)?
15. Have you successfully done work that required you to identify what a customer or client needs?
16. Have you successfully dealt with a disruption to regular operations in a way that allowed for completion of the work or continuation of a noncritical service?
17. Have you successfully done work that regularly involved planning, prioritizing, scheduling, and monitoring work for fewer than 10 people?
18. Have you effectively served on a problem-solving, planning, or goal-setting committee or team?
19. Have you effectively participated as a member of an extracurricular school team or community team (for example, sports, cheerleading, debate, theater, neighborhood watch, etc.)?
20. Since high school, have you received a grade of B or above in oral communication classes (for example, speech, public speaking, theater, etc.) or participated in activities that improved your oral communication skills (for example, training classes, workshops, seminars, debate team, speech club, etc.)?
21. Have you effectively worked on a team that was quickly established to function in a crisis situation (for example, worked on a search and rescue mission)?
22. Have you made presentations where you successfully persuaded someone to do something (for example, support a project, accept your recommendations, purchase a product or service, etc.)?
23. Have you developed a formal mechanism to learn more about a problem (for example, developed a survey, conducted interviews or focus groups, etc.)?
24. Have you identified and solved a problem with a procedure, product, or service that benefited the organization (for example, saved the organization time or money, increased sales, reduced errors, etc.)?
25. Have you successfully done work that constantly required you to work under difficult time constraints?
26. Have you formally taught, instructed, or trained others in educational or occupational settings and received favorable feedback about your ability to do so?
27. Have you successfully done work, not including computer applications classes, that regularly involved using statistical software programs to analyze data?
28. Have you worked on a team that produced measurable improvements (for example, an increase in production, quality, customer satisfaction, or a decrease in costs, number of injuries, complaints, etc.)?
29. Have you participated in training classes, workshops, or seminars outside of school that helped you improve your self-management skills (for example, time management, goal setting, career development, etc.)?
30. Have you successfully completed a complex research project that included collecting and analyzing information, and reporting conclusions or recommendations?
31. Have you often been asked to proofread or edit the writing of others for content, punctuation, spelling, and grammar?
32. Have you successfully done work that regularly involved conducting quality checks or following up with customers or clients to ensure satisfaction with a product or service?
33. Have you received favorable feedback about your interpersonal skills when serving as a leader, instructor, or supervisor for academic, religious, community, sports, leisure, or work activities?
34. Have you successfully done work, not including computer applications classes, that regularly involved using word processing software to create, edit, and format documents or correspondence?
35. Have you broken a sales record or a similar record, regularly exceeded quotas or similar productivity standards, or received formal recognition for doing work that surpassed what was expected (for example, received a certificate of appreciation, bonus, etc.)?
36. Have you designed or developed something, on your own initiative, to help you or other employees better complete assignments (for example, designed a training manual)?
37. Have you successfully provided quality service to people with special needs or problems (for example, worked in a hospital, halfway house, special education program, etc.)?
38. Have you successfully done work that regularly involved answering questions, gathering nonsensitive information, or providing assistance to others, either in person or by telephone?
39. Have you successfully done work that regularly involved listening carefully to others to understand a need, problem, or situation (for example, investigative work, counseling, etc.)?
40. Have you successfully completed a small-scale project (lasting several days or weeks) on or ahead of schedule with minimal supervision?
41. Have you successfully done work that involved writing technical or legal reports, or translating technical or other complex material into language that was more easily understood?
42. Have you successfully created computerized databases to organize information?
43. Have you received formal recognition (for example, received an award, letter of commendation, etc.) or been given certain assignments because of your ability to work well in a group?
44. Have you successfully completed a large-scale project (lasting several months or longer) on or ahead of schedule with minimal supervision?
45. Have you successfully written reports that presented facts, findings, logical conclusions, and persuasive arguments (for example, wrote a thesis, briefing papers, policy papers, complex research papers, etc.)?
46. Have you received formal recognition for your ability to work well with others (for example, received a letter of recommendation or appreciation, an excellent performance appraisal rating, etc.)?
47. Have you taken the initiative to learn new skills or acquire additional knowledge that improved your performance at work or school, or in leisure activities?
48. Have you successfully done work that involved identifying the type of training needed by an individual or group?
49. Have you successfully coordinated work, school, and/or family responsibilities under especially difficult circumstances (for example, you and your spouse worked full time while raising young children, you went to school full time and worked more than 20 hours per week, you worked full time while caring for an elderly parent, etc.)?
50. Have you successfully done work that regularly involved manipulating data in a computer database (for example, importing, exporting, merging, updating, sorting data, etc.)?
51. Have you successfully done work where trust and cooperation were a matter of life and death (for example, firefighting, combat duty, law enforcement, rescue work, etc.)?
52. Have you successfully planned activities for nonwork groups (for example, athletic teams, professional associations, religious groups, etc.)?
53. Have you taught a nonacademic skill to others on a voluntary basis (for example, taught camping to scouts, photography, cooking, waterskiing, etc.)?
54. Have you successfully done work that regularly involved discussing sensitive information with others, or interviewing or surveying people, either in person or by telephone, to gather information they were reluctant to give?
55. Have you written procedures or instructions that others have followed successfully (for example, instruction manuals, survey instructions, training materials, etc.)?
56. Have you successfully done work that regularly involved using computer software to run a payroll, accounting, or inventory system, or to record or track other quantitative information?
57. Have you successfully done work that regularly involved relaying messages to co-workers, or providing information or giving simple instructions to customers or the public, either in person or by telephone (for example, worked as a receptionist, dispatcher, etc.)?
58. Have you successfully completed a long-term project outside of work where you were solely responsible for doing the work (for example, completed a thesis, wrote a book that was published, prepared a horse for competition that won a ribbon, restored an antique car, etc.)?
59. Have you provided formal training to others in a specialized area of knowledge outside of work or academic settings (for example, taught self-help classes, religious instruction, etc.)?
60. Have you successfully done work that regularly involved interacting with people, other than your co-workers, from a foreign country or from different ethnic or cultural backgrounds?
61. Have you successfully done work that regularly involved verifying the accuracy of information or the relevance of information to a problem or a situation (for example, investigative work)?
62. Have you successfully done work that regularly involved interacting with or counseling people with special needs or problems (for example, hospital patients, psychiatric patients, prisoners, people who are elderly or disabled, etc.)?
63. Do you regularly monitor your progress toward achieving your career goals (for example, by initiating discussions about your career goals with your supervisor, employee counselor, mentor, etc.)?
64. Have you successfully developed, updated, or enhanced materials for a training/educational program or class?
65. Have you successfully worked closely with a client over an extended period of time to complete a project or resolve a problem?
66. Have you done work that regularly involved providing constructive feedback to others (for example, when grading class papers, when conducting on-the-job training or performance evaluations, etc.)?
67. Have you successfully remained courteous and tactful while enforcing laws or policies or helping customers, clients, or members of the public who were hostile or upset, not including handling customer complaints (for example, worked in a crisis center, worked as a police officer, parole officer, park ranger, etc.)?
68. Have you received favorable feedback for oral presentations you have given to management or other officials, or to the public (for example, for speaking at religious services, performing in theatrical productions, etc.)?
69. Have you successfully done work, not including computer applications classes, that regularly involved using graphics software to create and edit charts, tables, or graphs?
70. Have you been given additional responsibilities because of your ability to organize and complete your regular work more quickly than expected?
71. Have you successfully tutored someone in an academic subject or in study skills?
72. Have you done work that involved writing brochures, press releases, or speeches?
73. Have you suggested or made changes to products or procedures that resulted in better meeting customer needs?
74. Have you successfully done work that regularly involved informally providing oral explanations of technical information or other complex information, such as regulations, policies, or procedures?
75. Have you successfully done work that regularly involved answering questions, demonstrating a product or service, or providing assistance to customers, clients, or the public?
76. Have you successfully solved problems that occurred because of a critical emergency or a disruption of a life-saving operation, with very few resources or guidelines (for example, solved problems related to a natural disaster, a power outage in a hospital, etc.)?
77. Have you received formal recognition for providing good service to customers or clients (for example, received an award, a letter of commendation, an excellent performance appraisal rating, etc.)?
78. Have you successfully developed an automated system that improved accuracy, efficiency, or productivity?
79. Have you successfully planned or monitored a large-scale project or program that involved several steps that were carried out over an extended period of time?
80. Have you participated in training classes, workshops, or seminars outside of school that helped you improve your teamwork skills?
81. Have you successfully worked as an academic instructor (for example, school teacher, substitute teacher, student teacher, teaching assistant, professor, etc.)?
82. Have you successfully done work that regularly involved planning, prioritizing, scheduling, and monitoring work for 10 or more people?