Filled out sample application form for reference - US Department of ...

Describe your major duties/responsibilities and accomplishments.
writing contracts with local vendors
Reason(s) for leaving (Do not write “N/A” or applicable)
N/A
25b. Job Title (If U.S. Government, include the Series and Grade)
none
From - - To - -
(mm-dd-yyyy) (mm-dd-yyyy)
Employer’s Name and Address
Salary per Year in U.S. Dollars or
Local Currency
Supervisor’s Name and Contact Information
Name
Describe your major duties/responsibilities and accomplishments.
Reason(s) for leaving (Do not write “N/A” or applicable)
25c. Job Title (If U.S. Government, include the Series and Grade)
From - - To - -
(mm-dd-yyyy) (mm-dd-yyyy)
Employer’s Name and Address
Phone Number
E-mail Address
Salary per Year in U.S. Dollars or
Local Currency
Supervisor’s Name and Contact Information
Name
Describe your major duties/responsibilities and accomplishments.
Reason(s) for leaving (Do not write “N/A” or applicable)
25d. Job Title (If U.S. Government, include the Series and Grade)
From - - To - -
(mm-dd-yyyy) (mm-dd-yyyy)
Employer’s Name and Address
Phone Number
E-mail Address
Salary per Year in U.S. Dollars or
Local Currency
Supervisor’s Name and Contact Information
Name
DS-174 Page 4
12-2009
Hours Per Week
Hours Per Week
Hours Per Week