Overseas Pre-Employment Data Form - Dodea
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3OVERSEAS PRE-EMPLOYMENT DATA FORM
Personal Data:
Name: _____________________________ Social Security Number:_____________________
Citizenship: __________________
Date of Birth: ______________________
Typing-Words Per Minute: _________
Employee Preferences
Work Schedule: Full Time:
Part Time:
Minimum # of hours willing to work per week: __________
Employment Type: Permanent
Temporary
Employment Categories - Choose all that are applicable: (Please see instruction form for definitions)
30% Disabled Veteran
VRA Eligible
VEOA Eligible
Transfer Eligible
Reinstatement Eligible
ICTAP Eligible
NAF Interchange Eligible
Military Spouse Preference Eligible
Family Member Eligible
Military Spouse Preference Eligible for Executive Order 13473
Reemployed Annuitant
Current/ Previous Federal Civilian Employee Information
Currently Working for Federal Government: Yes
No
Where: ___________________________
How many hours per week?: _____
Is the position: Permanent Yes
No
Temporary Yes
No
Currently a career/career conditional federal employee:
Yes
No
Are you a Federal Civil Service Retiree: Yes
No
Currently on Leave Without Pay:
Yes
No
Expiration Date:_____________
Have you ever accepted a Voluntary Separation Incentive Payment: Yes
No
Date: ________
Highest Grade Held and Pay Plan:
Pay Plan:_____ Grade:______
Start Date:____________ End Date:____________
Last Performance Appraisal Fully Successful or Better:
Yes
No
Date of Performance Appraisal:____________
Overseas Status Information
Sponsor: Active Duty Military
DoD Civilian-USA Hire
DoD Civilian-Local Hire
US Citizen Employed as a Contractor
Self- I am the Sponsor
Relationship to Sponsor:__________________
Sponsor’s DEROS Date:__________________
Dual National:
Yes
No
Country:____________________
Have a residence/work permit in Country Outside US: Yes
No
Countries:______________________________
Visa Type:______________ Visa Expiration:_______________
Date arrived in Host Country:___________________
Are you presently living in a host country without affiliation with US military forces or a civilian component:
Yes
No
_______________________________________
____________
Signature
Date
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