AD-779

EMPLOYEE BIOGRAPHICAL SKETCH

1. NAME:		VACANCY NUMBER:
	ELECTRONIC MAILING ADDRESS:
	SURFACE MAILING ADDRESS:
	PHONE NUMBER:

2. EXPERIENCE: (List last 15 years, beginning with the most RECENT DATE. Clearly identify any temporary promotions.)

DATES (From MO/YR)

POSITION TITLE, SPECIALTY SERIES, GRADE/STEP

ORGANIZATION NAME/LOCATION NAME & TELEPHONE NO. OF IMMEDIATE SUPERVISOR

3. APPLICABLE EDUCATION AND TRAINING: (Beyond High School)

DEGREE:

MAJOR/MINOR:

DATE OF GRADUATION:

4. LAST OFFICIAL PERFORMANCE RATING: (Check Appropriate Level)

Outstanding

Superior

Fully Successful

Marginal

Unacceptable

OFFICIAL RATING MAY BE REQUESTED PRIOR TO SELECTION

May we contact your supervisor without first notifying you?	YES	NO
Current Supervisor’s Name:
Supervisor’s Work Phone:

5. LIST, BY DATE, ANY AWARDS, CITATIONS, OR SPECIAL ASSIGNMENTS: