Veterans' Hiring Preference Form - Yamhill County, Oregon

This printable "Veterans' Hiring Preference Form" is a document issued by the Oregon Department of Veterans Affairs specifically for Oregon residents.

Download a PDF of the latest edition of the form down below or find it through the department's forms library.

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Veterans’ Hiring Preference Form
YAMHILL COUNTY HUMAN RESOURCES
Office Location: 434 NE Evans Street
th
Mailing Address: 535 NE 5
Street
McMinnville, Oregon 97128
(503) 434-7308 Phone • (503) 434–7553 Fax •
employment@co.yamhill.or.us
Name: _____________________________ Position Title & Job Number: _____________________________
Under Oregon law ORS 408.225 – 408.238, veterans who meet the minimum qualifications for a position may be
eligible for hiring preference. If you think you may qualify as either a veteran or a disabled veteran, please read
the following checklist carefully. Check the box for each item that is appropriate. Please contact Yamhill
County’s Human Resources office with any questions.
This completed form and required documentation must be submitted to Yamhill County Human Resources
at the time you submit your employment application.
A. QUALIFIED VETERAN QUESTIONS: You may claim veterans’ hiring preference if you can check at
least one box in each of the two sections below and provide proof of eligibility by submitting a copy of your
DD-214 or DD-215 that includes your discharge status (e.g. honorable discharge).
Section One
I served on active duty* with the Armed Forces of the United States for a period of more than 178
consecutive days and was discharged or released from active duty under honorable conditions; or
I served on active duty* with the Armed Forces of the United States for 178 days or less and was
discharged or released from active duty under honorable conditions and have a disability rating from the
United States Department of Veterans Affairs; or
I served on active duty* with the Armed Forces of the United States for at least one day in a combat zone
and was discharged or released from active duty under honorable conditions; or
I received a combat or campaign ribbon or an expeditionary medal for service in the Armed Forces of the
United States and was discharged or released from active duty under honorable conditions; or
I am receiving a non-service connected pension from the United States Department of Veterans Affairs.
* Attendance at a school under military orders, except schooling incident to an active enlistment or regular tour of
duty, or normal military training as a reserve officer or member of an organized reserve or National Guard unit is
not considered active duty.
Section Two
This application is to apply for a job with Yamhill County; or
This application is to apply for a promotion. After my initial regular status appointment to a Yamhill
County position, I was granted military leave to serve in the armed services for more than 178 days, and
then returned to County service.
Veterans’ Hiring Preference Form
YAMHILL COUNTY HUMAN RESOURCES
Office Location: 434 NE Evans Street
th
Mailing Address: 535 NE 5
Street
McMinnville, Oregon 97128
(503) 434-7308 Phone • (503) 434–7553 Fax •
employment@co.yamhill.or.us
Name: _____________________________ Position Title & Job Number: _____________________________
Under Oregon law ORS 408.225 – 408.238, veterans who meet the minimum qualifications for a position may be
eligible for hiring preference. If you think you may qualify as either a veteran or a disabled veteran, please read
the following checklist carefully. Check the box for each item that is appropriate. Please contact Yamhill
County’s Human Resources office with any questions.
This completed form and required documentation must be submitted to Yamhill County Human Resources
at the time you submit your employment application.
A. QUALIFIED VETERAN QUESTIONS: You may claim veterans’ hiring preference if you can check at
least one box in each of the two sections below and provide proof of eligibility by submitting a copy of your
DD-214 or DD-215 that includes your discharge status (e.g. honorable discharge).
Section One
I served on active duty* with the Armed Forces of the United States for a period of more than 178
consecutive days and was discharged or released from active duty under honorable conditions; or
I served on active duty* with the Armed Forces of the United States for 178 days or less and was
discharged or released from active duty under honorable conditions and have a disability rating from the
United States Department of Veterans Affairs; or
I served on active duty* with the Armed Forces of the United States for at least one day in a combat zone
and was discharged or released from active duty under honorable conditions; or
I received a combat or campaign ribbon or an expeditionary medal for service in the Armed Forces of the
United States and was discharged or released from active duty under honorable conditions; or
I am receiving a non-service connected pension from the United States Department of Veterans Affairs.
* Attendance at a school under military orders, except schooling incident to an active enlistment or regular tour of
duty, or normal military training as a reserve officer or member of an organized reserve or National Guard unit is
not considered active duty.
Section Two
This application is to apply for a job with Yamhill County; or
This application is to apply for a promotion. After my initial regular status appointment to a Yamhill
County position, I was granted military leave to serve in the armed services for more than 178 days, and
then returned to County service.
B. QUALIFIED DISABLED VETERAN QUESTIONS: You may claim disabled veterans’ hiring preference
if you can check at least one box in each of the two sections below and provide proof of eligibility by
submitting both:
1.
A copy of your DD-214 or DD-215 showing your discharge status; and
2. A copy of your letter from the Department of Veterans Affairs stating your disability rating and dated
within the previous six months of the date of your employment application.
Section One
I am entitled to disability compensation under laws administered by the Department of Veterans Affairs;
or
I was discharged or released from active duty for a disability incurred or aggravated in the line of duty; or
I was awarded the Purple Heart for wounds received in combat.
Section Two
This application is to apply for a job with Yamhill County and I am officially certified as having service-
connected disabilities; or
This application is to apply for a promotion. After my initial regular status appointment to a Yamhill
County position, I was granted military leave to serve in the armed services for more than 178 days, and
then returned to County service.
C. SIGNATURE SECTION: This section must be completed.
I hereby claim veterans’ hiring preference and certify that the above information is true and correct. I understand
that any false statements may be cause for my disqualification or dismissal, regardless of when discovered.
Entry into Service: ___________________________ Discharge from Service: ___________________________
Branch of Service: _____________________________________
NOTE: This form must contain a written signature if you drop it off at the employment office or submit it via
mail or fax. This form must contain an electronic signature if submitted via e-mail. (If submitted with an
electronic signature, you will be required to sign this form at the interview, if you are selected to interview.)
Written Signature
Electronic Signature
(Type name. Electronic signature
required only when submitting form via e-mail.)
______________________________________
_______________________________________
Date _________________________________
Date __________________________________
Hiring preference will not be awarded without the appropriate documentation. You must submit a copy of this form, your DD-214
or DD-215 that shows discharge status, and a Yamhill County employment application for each position you are applying for. You
must submit these documents each time you apply for a position with Yamhill County. You will not receive hiring preference
consideration without these accompanying documents.
Form created 3/14/12
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