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1. Which of the following items describes your current or recent (within the last five years) political appointee service?

If you responded yes to any of the items below, you will need to include a SF-50 specifying your prior service.

A. Yes, I am considered a political appointee as described under 5 U.S.C. sections 5312 through 5316.

B. Yes, I am considered a Non-career Senior Executive Service (SES), Limited Term SES, Limited Emergency SES Executive Branch employee.

C. Yes, I am considered a political Schedule A, Schedule C, or appointee who served in a political capacity under agency-specific authority in the Executive Branch.

D. Yes, I am considered a political appointee in the Executive Branch (as described in a., b. or c above) in a covered position in an agency having an interchange agreement with OPM, which allows movement from the agency's system to the competitive civil service.

E. None of the above. I am not considered a current or recent (last 5 years) political appointee as described above in items a, b, c, or d.

Your resume must be submitted in English and include the following information for each job listed:

Job title Duties (be as detailed as possible)
Month & year start/end dates (e.g. June 2007 to April 2008)
Full-time or part-time status (include hours worked per week)
Series and Grade, if applicable, for all Federal positions you have held
Please be aware that your answers will be verified against information provided on your resume. Be sure that your resume clearly supports your responses to all of the questions by addressing your work experience in detail.

Recommended: Even though we do not require a specific resume format, your resume must be clear so that we are able to fully evaluate your qualifications. To ensure you receive appropriate consideration, please list the duties you performed under each individual job title. If we are unable to match your experiences with the positions held, you may lose consideration for this vacancy. We cannot make assumptions regarding your qualifications. Do not include a photograph or video of yourself, or any sensitive information (age, date of birth, marital status, protected health information, religious affiliation, social security number, etc.) on your resume or cover letter. We will not access web pages or encrypted, and digitally signed documents linked on your resume or cover letter to determine your qualifications.

By submitting your application, you are certifying, to the best of your knowledge and belief, all the information submitted by you with your application for employment is true, complete, and made in good faith, and that you have truthfully and accurately represented your work experience, knowledge, skills, abilities and education (degrees, accomplishments, etc.). The information you provide as part of your application may be investigated. You are also certifying, and acknowledging, that misrepresenting your experience or education, or providing false or fraudulent information in, or with your application, may affect your eligibility for appointment and/or continued employment. False or fraudulent statements may be punishable by fine or imprisonment (18 U.S.C. 1001).

Assessment 1

The assessment part of the questionnaire includes questions about your eligibility and minimum qualifications related to this position. Select the appropriate answer to each of the following questions based on your current level of education and/or experience that demonstrates your ability to perform the duties of this position. When answering the questionnaire, remember that your experience and/or education are subject to verification by investigation. You may be asked to provide specific examples or documentation of experience or education as proof to support your answers, or you may be required to verify a response by a practical demonstration of your claimed ability to perform a task.

Select “Yes” or “No” to the following question(s).

1. Are you proficient in spoken and written English? [To be appointed under authority of 38 U.S.C., chapter 73 or 74, serving in a direct patient-care capacity in VHA, applicants must be proficient in written and spoken English.]

A. Yes

B. No

2. Are you a graduate of a school of professional nursing. approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed?

EDUCATION: Graduate from a professional school of nursing accredited by one of the following at the point of graduation is required:

Accreditation Commission for Education in Nursing (ACEN); or Commission on Collegiate Nursing Education(CCNE)

OR

a graduate of a foreign school of professional nursing.

Note: The National League for Nursing Accrediting Commission/NLNAC changed its name to ACEN in May 2013; ACEN's website may be utilized to verify accredited programs using automated inquiry processes; however, for verification of any nursing program's accreditation prior to 1998, an automated inquiry cannot be used and ACEN must be contacted directly

ACEN or CCNE Accreditation - Candidates meeting the basic education requirement of graduation from an ACEN or CCNE accredited nursing program must be considered before consideration of a deviation to the basic accreditation requirement

Nursing Bridge Program (must be appropriately accredited): A masters-level nursing accelerated nursing education program: The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. A copy of the MSN transcript must be provided to VA. Bridge programs that confer a master's degree also fully meet the education requirement, even though a Bachelor's Degree is not awarded.

Foreign Nursing Education

Graduates of foreign schools of professional nursing who, possess a current, full, active and unrestricted registration, will meet the education requirement of graduation from an approved school of professional nursing to warrant appointment as a Nurse who has completed an associate degree/entry level Nursing education program

Credit for foreign nursing education higher than the associate degree/entry level requires a formal degree equivalency validation from a recognized degree equivalency evaluation agency accepted by VA such as the International Consultants of Delaware (ICD)

A. Yes

B. No

3. Do you possess a current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the U.S. or in the District of Columbia?

Licensure and Certification. The following licensure and certification requirements are considered conditions of employment.

(1) Nurse. All Nurses must possess and maintain an active, current, full and unrestricted license as a Nurse to practice in a State, Territory or Commonwealth of the United States, or in the District of Columbia.

A. Yes

B. No

4. This position is open to current permanent employees of the Syracuse VA Medical Center and/or associated community-based outpatient clinics only. Are you a current permanent employee of the Syracuse VA Medical Center and/or associated community-based outpatient clinics?

A. Yes

B. No

IMPORTANT NOTE: Resume Reminder: Your resume must include the following information for each job listed: Name, Job Title, Duties (be as detailed as possible), Month & Year to include Start/End Dates, Full Time or Part Time status (include part time hours worked per week). Recommended: Even though we do not require a specific resume format, your resume must be clear so that we are able to fully evaluate your qualifications. To ensure you receive appropriate consideration, please list the duties you performed under each individual job title. If we are unable to match your experiences with the positions held, you may lose consideration for this vacancy. We cannot make assumptions regarding your qualifications.

Terms & Conditions

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