1. Government-wide regulations require that candidates be citizens of the United States, expect when no qualified U.S. citizens are available. Are you a United States Citizen?A. Yes, I am a U.S. Citizen
2. Do you possess a doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA)?A. Yes
3. Have you successfully completed a professional psychology internship training program that has been accredited by the American Psychological Association?A. Yes
4. Do you possess a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia.A. Yes, I currently possess a full, current, and unrestricted license.
5. Psychologists appointed to direct patient-care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d) and 7407(d). Are you proficient in the spoken and written English language?A. Yes
The following is a Certification of Understanding. RESPONSE TO THIS STATEMENT IS MANDATORY. Please note, if you do not answer this question, it will result in not being considered for this position.
6. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled; I may be denied an appointment; or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated and that responding "No" or providing no response to this item will result in my not being considered for this position.A. Yes, I certify that the information provided in this questionnaire is true, correct and provided in good faith, and I understand the information provided above.
7. Please choose the ONE statement below that applies to you:A. I am eligible for tentative ("5-point") preference.
Veterans who served on active duty in the U.S. Armed Forces and were separated under honorable conditions may be eligible for veterans' preference. For service after October 15, 1976, the veteran must have received a Campaign Badge, Expeditionary Medal, a service connected disability, or have served during the Gulf War between August 2, 1990 and January 2, 1992 or for more than 180 consecutive days, other than training, any part of which occurred during the period beginning September 11, 2001, and ending on the date prescribed by Presidential proclamation or by law as the last day of Operation Iraqi Freedom. To claim veterans' preference, veterans should be ready to provide a copy of their DD-214, Certificate of Release or Discharge from Active Duty, or other proof. Veterans with service connected disability and others claiming "10 point preference" will need to submit Form SF-15, Application for 10-point Veterans' Preference.
VETERANS' PREFERENCE DOCUMENTATION REMINDER - If you claim eligibility for veterans' preference, you must submit documentation to support your claim. Submit a DD-214 (or equivalent document) reflecting your discharge type and, if claiming 10-point preference, an SF-15, Application for 10-Point Veterans' Preference, along with the appropriate supporting documentation. For more information on Veterans' Preference, go to www.fedshirevets.gov/job/veterans.aspx
REMINDER - In addition to completing this questionnaire, you MUST submit a complete Application Package that includes - at a minimum - a resume, VA form 10-2850c, Optional Form 306, education transcripts, and any other required documentation (see How to Apply section of announcement). Be certain that your resume and/or application form provides complete information regarding each job listed (title, description of duties, average number of hours worked per week, and the month/year for the starting and ending dates of employment), your qualifying education, and your qualifying license (if applicable).