Fillable Form DS-1950 APPLICATION FOR EMPLOYMENT

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Form DS-1950 APPLICATION FOR EMPLOYMENT

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The Form DS-1950 APPLICATION FOR EMPLOYMENT form is 7 pages long and contains:

  • 2 signatures
  • 157 check-boxes
  • 142 other fields

Country of origin: US
File type: PDF

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The US Department of State (DOS) or the State Department, is the government official division that advises the President and performs international relations. Equivalent to the outside service of different nations, it was built up in 1789 as the country's first official department.

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SPECIFIC INSTRUCTIONS
Page 1
#5. If applicable, include your apartment number at the end of your street address.
#6, 7. Include area codes for all phone numbers. Use the following format: 202-555-1234.
#12. If you are a male and were born prior to December 31, 1959, you should NOT answer item #12.
#13. To qualify for Veteran's Preference, you must have been discharged or released from active duty in the armed forces under
honorable conditions performed under ONE of the following conditions:
In a war; or
In a campaign or expedition for which a campaign badge has been authorized; or
During the period beginning April 28, 1952, and ending July 1, 1955; or
For more than 180 consecutive days, other than for training, any part of which occurred during the period
beginning February 1, 1955, and ending October 14, 1976; or
During the Gulf War from August 2, 1990, through January 2, 1992; or
For more than 180 consecutive days, other than for training, any part of which occurred during the period
beginning September 22, 2001, and ending on the date prescribed by Presidential proclamation or by law as the
last day of Operation Iraqi Freedom; or
Are a disabled veteran.
You will be required to submit a completed SF-15 and/or DD-214, along with any proof requested, to receive Veteran's
Preference. (Please note that Veterans' Preference eligibility is governed by 5 U.S.C. 2108 and 5 CFR Part 211. All conditions
are not fully described on this form because of space restrictions. For additional information, please refer to the specific
regulations.)
#16, 17. Mark only one box per item. For #16, indicate the highest level of education you have completed. For #17, mark the box
that most closely indicates your present status.
#18, 19, 20. List the most recently attended schools for each of these items. On Page 5, you have more space to list schools
where you received additional degrees or certificates, such as from Vocational/Technical programs. Use the following format for
"Date of Diploma/GED" and "Date of Degree": mm-yyyy (e.g. 04-1994). For "Date From" and "Date To" use mm-yyyy (e.g.
04-2000).
DS-1950
xx-xxxx
Instruction Page 1 of 2
INSTRUCTIONS
Carefully Read the Following Instructions and the Vacancy Announcement Before You Complete this Application
THIS APPLICATION IS REQUIRED FOR CERTAIN EMPLOYMENT OPPORTUNITIES IN THE
DEPARTMENT OF STATE. TYPE OR PRINT CLEARLY IN BLACK INK. NOTE: Illegible statements on
the application form may hinder full consideration of your application. Data on the application form are
read by computer. Using care while filling in the form will speed processing of your application. TYPING
IS PREFERRED. If you plan to type this application, first fill in the boxes (items #10, 11, 12, etc.) with
black ink. If you plan to handwrite, print carefully and close letters.
Before completing this application, determine from the appropriate office if applications are being accepted for the position in
which you have an interest and, if so, obtain a vacancy announcement from that office. In addition to describing the job, the
announcement will help you determine if you have the appropriate qualifications and how to present them, advise whether any
additional application documents are needed, and explain how to submit the application and any supplemental documents.
You must submit at least the following parts of this application (refer to the vacancy announcement for complete instructions on
what to submit): one Page 1, one Page 2, one Page 3 and one page 5. On each Page 2, 3 and 4 you submit, enter your Social
Security Number and up to the first 18 characters of your last name. You may submit more than one Page 2 depending on the
number of experience blocks you need, but only one Page 3.
When completing date (except item # 18 - "Date of Diploma/GED" and items #19 and 20 - "Date of Degree"), use the following
format: MM-DD-YYYY.
Answer all questions fully and correctly. Otherwise, you may delay the review of your application and exclude yourself from
consideration for employment. See the vacancy announcement for the fax number and/or mailing instructions and for any
required additional submissions and attachments. You must keep a copy of this application with an original signature. At some
point in the selection process, you may be asked to submit original copies of your application and attachments. If you plan to
make copies of your application, we suggest you leave items #9, 24 and 25 blank, so you can use this application for future
vacancies. Complete these blank items each time you apply. YOU MUST SIGN AND DATE, IN INK, EACH COPY YOU
SUBMIT.
APPLICATION FOR EMPLOYMENT
3-minimum Professional Proficiency
4-Full Professional Proficiency
Able to read some personal and place
names, street signs, office and shop
designations, numbers and isolated words
and phrases.
Proficiency Code Speaking Definitions Reading Definitions
0-No Practical Proficiency No Practical speaking proficiency No Practical Reading proficiency
1-Elementary Proficiency Able to satisfy routine travel needs and
minimum courtesy requirements.
2-Limited Working Proficiency Able to satisfy routine social demands and
limited work requirements.
Able to read simple prose, in a form
equivalent to typescript or printing, on
subject within a familiar context.
Able to speak the language with sufficient structural
accuracy and vocabulary to participate effectively in
most formal and informal conversations on practical,
social, and professional topics.
Able to read standard newspaper items
addressed to the general reader, routine
correspondence, reports, and technical
materials in the individual's special field.
Able to use the language fluently and accurately on all
levels pertinent to professional needs.
Able to read all styles and forms of the
language pertinent to professional needs.
5-Native or Bilingual Proficiency Equivalent to that of an educated native speaker. Equivalent to that of an educated native.
#22. Rate your proficiency for speaking and reading languages other than English. Be sure to include the two languages in which
you have the highest proficiency. If you wish to list more than two languages in which you have proficiency, give details in the
"Continued Items" area on Page 3. Rate your proficiency using the codes listed below:
DS-1950
Instruction Page 2 of 2
Pages 2 and 3
Fill in your employment, unemployment, and education activities, beginning with the present and working backwards 10 years.
Label each experience with a consecutive letter (A, B, C, D, etc.) beginning with the letter "A" in the first "Experience Block".
INCLUDE ALL: full-time work, part-time work, temporary work, paid work, unpaid work, active military duty, self-employment,
periods of unemployment, educational activities (for unpaid activities, leave the salary blocks blank). You may also include any
other experience prior to the past 10 years which you feel would be relevant to the position for which you are applying. If you had
a significant change of duties or responsibilities while you worked for the same employer, describe each major change as a
separate experience. If specific experience continues to the present, mark the box for "Present" and do not mark the "Date To"
blocks.
Note: If you receive the application by fax and the four corner boxes are cut off at the top or bottom of any page, please contact the sending
office to resend the fax or request a form by mail. The form may not read properly if the boxes are not intact.
INSTRUCTIONS (Cont'd)
APPLICATION FOR EMPLOYMENT
PRIVACY ACT STATEMENT
Authority: This form is authorized by 5 U.S.C. 3301.
Purpose: The information requested will be used to conduct an investigation to determine an applicant's suitability for
employment and/or your ability to obtain a security clearance.
Routine Uses: This information may be given to Federal, State, and local law enforcement agencies to check for criminal and/or
civil violations. Your name and address may be submitted to other federal U.S. Government agencies and Congressional offices
and/or committees and international organizations, if requested for potential employment opportunities. If you are selected for
Federal employment, we may also notify your college or university placement office.
Solicitation of your Social Security number is authorized by Executive Order 9397. Respondents Social Security numbers (SSN)
will be used to identify records as other individuals may have the same name and birth date.
Disclosure: Although the information requested in this application (including your Social Security number) is voluntary; your
application will not be processed if you fail to disclose any such information (including your Social Security number).
17. Current Student
Status
Full-Time Student
Part-Time Student
Not a Student
18. High School Name
11. Are you a U.S. Citizen?
Is your spouse/cohabitant a U.S. Citizen?
If "NO", enter the country of his/her citizenship.
21. Do you have or have you had a Security Clearance?
16. Highest Education Level Completed
14. Were you ever employed as a civilian by the
Federal Government? If "YES" mark all that apply.
10. Are you available for: (Select all appropriate)
City, State, ZIP Code
13. Veteran's Preference
No Preference
5-Point Preference
10-Point Preference
12. If you are a male born
after December 31, 1959,
have you registered with the
Selective Service?
15. Do you have a
relative working for
the Agency for
which you are
applying? If "YES",
give details on
Page 5.
World Wide Assignment?
U.S. Department of State
Do you receive, or have you ever applied for retirement pay,
pension or other pay based on military, Federal civilian, or
District of Columbia Government service?
If "YES", what type of clearance and who issued the
clearance?
1. Name (Last, First, MI.)
3. Date of Birth
2. Other Names Ever Used (Maiden, Nicknames, etc.)
4. Social Security Number
5. Current Address (Include apartment number, if any)
5a. City
5e. Country
Grade Point Avg.
23. List any special skills (e.g. computer),experiences,
current licenses, honors, awards, special accomplishments,
and/or training (with date completed) relating to the
position for which you are applying. Continue on Page 5,
if necessary.
APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer
22. First Foreign Language Proficiency
Date of Diploma/GED
Number of credit hours
completed
City, State, ZIP Code, Country
Grade Point Avg.
Number of credit hours
completed
19. Undergraduate Institution
Date of Degree
City, State, ZIP Code, Country
20. Graduate Institution
Date of Degree
Quarter hours completed
Semester hours completed
Major
Minor
24. Original Signature (SIGN IN INK) I certify that all of the information on and attached to this
application is true, correct, complete, and made in good faith.
Semester hours completed
Quarter hours completed
Date From (mm-yyyy) Date To (mm-yyyy)
Major Minor
Full-Time?
Temporary/Part-Time?
Overtime?
Shift Work?
Flexible Work Schedule?
7. Permanent Address
7a. Permanent City
7d. Permanent Country (If not United States)
7c. ZIP/Postal Code
7e. Permanent Home Phone
7b. State (Two Letters)
6. Current Home Phone
6a. Current Work Phone
5b. State
*OMB Approved No. 1405-0139
Expires 06-30-2017
Estimated Burden 30 Minutes
*The response time is an estimated average including the time needed to look for, get and provide the information required. You do not have to provide the information
requested if the OMB approval has expired. We would appreciate any comments on the estimated responses and cost burdens, and recommendations for reducing them.
Please send your comments to A/GIS/DIR, U.S. Department of State, Washington, DC 20520.
Speaking Proficiency
Reading Proficiency
Job Announcement Number 9. Lowest Acceptable Annual Salary
Or Grade Level
8. Indicate Title, Position or Program you are applying for
Date From Date To
Second Foreign Language Proficiency
Temporary
Career ExceptedCareer-Conditional
S
Speaking Proficiency Reading Proficiency
R
25. Date Signed (mm-dd-yyyy)
DS-1950
07-2014
Page 1 of 5
5c. ZIP/Postal Code 5d. E-Mail Address
Yes No
12/GED
Vo/Tech Prog.
10
11
College: 1
College: BA/BS
College: 4
College: 3
College: AA
College: 2
Graduate Studies
Masters
Professional Degree
JD/other law degree
Doctorate
Yes No
Signature
Yes
No
Yes No
Yes No
Yes No
Mr.
Mrs.
Ms.
S R
Yes No
(mm-dd-yyyy)
(Two Letters)
(ZIP + 4)
(if not United States)
(Include Area Code)
(Include Area Code)
(include apartment number, if any)
(ZIP + 4)
(Include Area Code)
(mm-yyyy)
(mm-yyyy)
(if not U.S.)
(if not U.S.)
(on 4.0 scale) (on 4.0 scale)
(mm-yyyy)
(mm-yyyy)
(mm-yyyy)
(See Codes Page 2) (See Codes Page 2)
click to sign
signature
click to edit
Experience
Block
Supervisor's Name, Area Code and Telephone Number
Describe your duties and accomplishments (Include any knowledge, skills, and abilities listed in the vacancy announcement that you have gained from
this work experience).
Type of Experience
Full-Time/Part-Time
If present experience,
mark box and leave "Date
To" blank. Present
Social Security Number
Last Name
Exact Title of Your Job
To
Ending Salary
Employer's Name and Address (Include ZIP Code, if known) If Federal employment, civilian or military, list series, grade or rank, and if
promoted in this job, indicate the date of your last promotion.
Describe your duties and accomplishments
An Equal Opportunity Employer
Type of Experience
Experience
Block
Full-Time/Part-Time
Exact Title of Your Job
Date From (mm-dd-yyyy)
Starting Salary
To
Ending Salary
Date To (mm-dd-yyyy)
Employer's Name and Address (Include ZIP Code, if known) If Federal employment, civilian or military, list series, grade or rank, and if
promoted in this job, indicate the date of your last promotion.
Supervisor's Name, Area Code and Telephone Number
DS-1950
Page 2 of 5
per
Hr
Wk
Mo
Yr
per
Hr
Wk
Mo
Yr
per
Hr
Wk
Mo
Yr
per
Hr
Wk
Mo
Yr
Date From (mm-dd-yyyy)
Starting Salary
If present experience,
mark box and leave "Date
To" blank. Present
Paid
Unpaid
Unemployed
Education
Full-Time
Part-Time
If P/T, hours
per week
(Include any knowledge, skills, and abilities listed in the vacancy announcement that you have gained from
this work experience).
Paid
Unpaid
Unemployed
Education
Full-Time
Part-Time
If P/T, hours
per week
APPLICATION FOR EMPLOYMENT
Date To (mm-dd-yyyy)
per
Hr
Wk
Mo
Yr
per
Hr
Wk
Mo
Yr
APPLICATION FOR EMPLOYMENT (Cont'd)
An Equal Opportunity Employer
Item 22 continued
Item 23 continued List special skills, awards, accomplishments and/or training.
Type of Experience
Last Name
Experience
Block
Full-Time/Part-Time
Exact Title of Your Job
Starting Salary
To
If present experience,
mark box and leave "Date
To" blank.
Ending Salary
Date To (mm-dd-yyyy)
If Federal employment, civilian or military, list series, grade or rank, and if
promoted in this job, indicate the date of your last promotion.
Supervisor's Name, Area Code and Telephone Number
Language Speaking Proficiency Reading Proficiency
AUTHORIZATION TO FURNISH INFORMATION
I hereby authorize the U.S. Department of State to furnish to any organization or individual who is a potential funding source or organization all the information I
have furnished on this form, any official financial aid statement from any college or university, and any other information I have provided with respect to my
application for this position with the U.S. Department of State.
Signature Date (mm-dd-yyyy)
Name Relationship
Continued Items from Page 3
Item 15 continued. Include: father, mother, husband, wife, son, daughter,
brother, sister, uncle, aunt, first cousin, nephew, niece, father-in-law,
mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law,
stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half
brother, and half sister.
Items 19 & 20 continued. Other schools and/or certificate programs where
degrees were received or vocational, technical or armed forces schools
where certificates were received and not listed in blocks #19 or 20. Include
all information as requested in blocks #19 & 20.
DS-1950
Page 3 of 5
Social Security Number
Paid
Unpaid
Unemployed
Education
Full-Time
Part-Time
If P/T, hours
per week
Date From (mm-dd-yyyy)
Employer's Name and Address
(include ZIP Code, if known)
Describe your duties and accomplishments (Include any knowledge, skills, and abilities listed in the vacancy announcement that you have gained from
this work experience.)
click to sign
signature
click to edit
Careers.state.gov
Other Website (Please specify)
Department of State Diplomat in Residence
Department of State Recruiter
Listserv message from careers.state.gov
Friend or Relative Working for Department of State
Email Marketing
3. Years of Overseas
Experience
2. Years of Full-Time
Work Experience
SUPPLEMENTAL INFORMATION
APPLICATION FOR EMPLOYMENT (Cont'd)
An Equal Opportunity Employer
DS-1950 Page 4 of 5
Social Security Number
Last Name
5. How did you learn about the job for which you are applying? (You may select up to 3 choices)
4. Overseas Experience
Administrative/Management
Economics/Marketing
Banking/Finance
International Trade
Law
Teaching
Federal Government
Foreign Affairs
Media/Journalism
Fine Arts
Scientific/Technical
Clerical and Related
Sales/Service
Military
Other
(Please specify)
Student
Dependent
Peace Corps
Military
Government
Other
(Please specify)
Direct Mail
Commercial Career Fair
College Career Fair
Magazine (Please specify)
Military Transition Assistance Program or Military Career Fair
Newspaper (Please specify)
Professional Organizations (Please specify)
Poster
Radio Advertisement
Radio/TV Interview
School or College Career Counselor
Teacher, Professor or Other Faculty
Other (Please specify)
1. If employed, describe Field of Work. (Mark the appropriate box(es))
6. Race and Ethnicity Identification. The race and ethnic categories for federal statistics and administrative reporting are defined below. Please identify yourself
in terms of one or more of the following categories by marking the appropriate box(es).
4. People with Invisible (Hidden) Disabilities: Individuals who have a disability that is not visible to an onlooker. There are many disabilities such as
asthma, arthritis, heart disease, environmental illness, AIDS, chronic fatigue, psychiatric or mental illnesses, attention deficit hyperactivity disorder,
learning disabilities, and mild mental retardation.
(1) American Indian or Alaska Native
(2) Asian
(3) Black or African American
7. Do you have a disability? (Voluntary)
Self-identification of disability status is essential for effective data collection and analysis. The information you provide will be used for statistical
purposes only. While self-identification is voluntary, your cooperation in providing accurate information is critical.
EMPLOYMENT DATA
An Equal Opportunity Employer
6. White
APPLICATION FOR EMPLOYMENT (Cont'd)
General instructions: The information from this survey is used to help ensure that agency personnel practices meet the requirements of Federal law. Your
responses are voluntary. Please answer each of the questions to the best of your ability. Please print entries in pen. Be sure to read each item thoroughly
before completing this form.
2. Social Security Number
3. Position for which you are applying
5 (a). Is this a Student Program position?
(b). If "YES", do you intend to enroll or continue to be enrolled in a college
or university immediately after completing the program?
Note: Race is defined by the Equal Employment Opportunity Commission as follows:
Definition of a Disability: A person is disabled if he or she has a physical or mental impairment which substantially limits one or more major life
activities; has a record of such an impairment; or is regarded as having such an impairment. Those disabilities that are to be reported are listed below.
In the case of multiple impairments, choose the code which describes the impairment that would result in the most substantial limitation on this job.
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
4. Job Announcement Number
A person having origins in any of the original peoples of North America and South America (including Central
America), and who maintains tribal affiliation or community attachment.
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, and Vietnam.
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin,
regardless of race. This category includes the term "Spanish origin," as well as "Hispanic" or "Latino."
A person having origins in any of the black racial groups of Africa. This category includes terms such as
"Haitian" or "Negro" as well as "Black" or "African American."
A person having origins in any of the original peoples of a Hawaii, Guam, Samoa, or other Pacific Islands.
1. American Indian or Alaska Native
2. Asian
4. Hispanic or Latino
3. Black, or African American
5. Native Hawaiian or Other Pacific Islander
DS-1950 Page 5 of 5
Yes No
If yes, please identify the disability using the codes below.
1. Name (Last, First, MI.)
Yes No
Yes No
Mr.
Mrs.
Ms.
Employment Data Self-Identification of Disability
1. Mobility Impairments: Individuals whose basic mobility, coordination, and balance, strength and endurance, and other aspects of body function are
affected by injuries or disease.
2. People Who Have Vision Impairments: Individuals who have either complete or partial loss of vision.
3. People Who Have Hearing Impairments: Individuals who may be deaf or hard of hearing.
5. People with Mental Retardation: Individuals who may not be able to think, reason or remember as well as others.
6. People with Psychiatric Disabilities: Psychiatric disabilities are diverse and include anxiety disorders, depression, bipolar disorders, schizophrenia,
and other conditions.
7. People with Muscular or Neurological Limitations: Muscular or neurological disabilities may affect motor ability and/or speech. You might observe
some involuntary or halting movement or limitation of movement in one or more than one appendage, as well as some lisping, indistinct speech or
flatness of tone due to lack of fine motor control of the tongue and lips. The severity and functional effects of the disability vary from person to person.
(4) Hispanic or Latino
(5) Native Hawaiian or Other Pacific Islander
(6) White
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Form DS-1950 APPLICATION FOR EMPLOYMENT

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Completed 21 February 2020

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