POSITION APPLIED FOR
Recruitment No. (on the job announcement)
Job Title:

·  Job opportunities are announced online at www.wsdot.wa.gov/employment/

·  Please use this form (WORD format) to enter all requested information and submit as a single document.

·  Copy and paste your letter of interest and resume into the specified area of this document.

·  Save this document and send it to the e-mail address indicated on the recruitment announcement no later than close of business on the deadline date.

·  With minor edits, this form can be used to apply for any WSDOT job opportunity.

CONTACT INFORMATION
Name (Last, First, and Middle Initial) / Day Phone No. / Cell Phone
Mailing Address (Include street number, city, state, zip code and apartment/unit number) / E-Mail Address

BACKGROUND

Are you a current or former permanent Washington State employee? YES NO
Do you possess a valid driver’s license? YES From what state and license number? NO
Have you been convicted of a misdemeanor or felony in the past ten (10) years? YES NO
NOTE: Answering “YES” to this question will not automatically exclude you from employment opportunities.
The WSDOT nepotism policy prohibits relatives or household members from working in any capacity that may create a conflict of interest. Answering “YES” to the following question will not automatically exclude you from employment opportunities. / Are you related to or residing with any current WSDOT employee(s)?
YES NO

EDUCATION

Have you graduated from high school or passed the General Education Development (GED) test? YES NO
Have you attended an accredited college or university: YES (Please complete table below) NO
School Name / City and State / Major / Number of Credits (Quarter/Semester) / Dates Attended
(mo/yr to mo/yr) / Type of Degree / Year Awarded
to
to
to
to
LICENSE OR CERTIFICATION (Example: EIT, PE, CDL, Flagging or other)
Name / Number / Expiration Date
LETTER OF INTEREST
Please copy and paste your letter of interest into the expanding box below. Your letter should clearly describe how you are a viable and competitive candidate for the position you are applying for based on the requisites listed in the job announcement. Letters may be up to two (2) pages in length.
RESUME
Please copy and paste your chronological resume in the expanding box below. If you do not have a resume, use the hyperlinked resume template to create one and copy and paste the information into box below. A hiring authority or human resource representative may contact your employers.
REFERENCES
WSDOT contacts the references of all position finalists and may speak with references to determine interviewees. None of the people you list below will be contacted without your permission. References should be able to attest to your character, work ethic, personality, professional skills and accomplishments. Immediate family or blood relatives should not be used as references. Before you list someone as a reference, please make sure you have contacted them.
Reference Name / Company/Organization / Phone Number / Email / Relationship (i.e. manager, employee, friend, colleague, etc.)
AFFIRMATIVE ACTION
Affirmative Action information is now collected through a secure portal. We appreciate your response and encourage you to fill out the online questionnaire by clicking on the “Applicant Profile” link found on the job announcement.

DATE AND SIGNATURE

I certify, to the best of my knowledge, the information provided on this application and any other materials I have submitted to apply for a WSDOT position are true and complete. I understand that the WSDOT will verify information contained in this application and untruthful or misleading answers are cause for rejection of my candidacy and/or immediate termination from WSDOT employment.
Electronic applications do not require a signature. When submitted electronically, you are confirming that all information is true and complete.
Signature / Date (Month/Day/Year)
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Washington State Department of Transportation is an equal opportunity employer. Persons with a disability who need assistance in the application or testing process, or those needing thisdocument in an alternative format, may call (360)705-7097. Applicants that are deaf or hard of hearing may call through the Washington Relay Service at 7-1-1.