U.S. CENSUS BUREAU RESUME FORM
FOR STUDENT EMPLOYMENT

Analysis
Mathematical Analysis
Information Technology
Geography
General Office / Office Assistant
Office Aide

*First Name:

Middle Name:

*Last Name:

*Date of Birth:

Email Address:

*Your permanent home address (street, city, state, and zip code) and phone number (including area code first)

*Your temporary school address (street, city, state, and zip code) and phone number (including area code first. If there is no school address, please repeat your home address here.)

*Are you a U.S. citizen?    Yes    No    If No, DO NOT PROCEED. United States Citizenship is required.

If male and born after December 31, 1959, are you registered with the Selective Service System?
    Registered    Not Registered    Exempt    Under Age 18    Not Applicable

Identify colleges and unversities attended. List current first to previous last.

School Name and State	Area of Study	Type of Degree	Year Degree Received/ Expected
	Pick One Economics Demography Psychology Sociology Other Social Sciences Mathematical/Statistical Computer Science Business Geography Public Administration Liberal Arts Physical Sciences Other	Pick One AA BA/BS MA/MS PhD	Pick One Prior to 1998 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 After 2010
	Pick One Economics Demography Psychology Sociology Other Social Sciences Mathematical/Statistical Computer Science Business Geography Public Administration Liberal Arts Physical Sciences Other	Pick One AA BA/BS MA/MS PhD	Pick One Prior to 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 After 2005
	Pick One Economics Demography Psychology Sociology Other Social Sciences Mathematical/Statistical Computer Science Business Geography Public Administration Liberal Arts Physical Sciences Other	Pick One AA BA/BS MA/MS PhD	Pick One Prior to 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 After 2005
	Pick One Economics Demography Psychology Sociology Other Social Sciences Mathematical/Statistical Computer Science Business Geography Public Administration Liberal Arts Physical Sciences Other	Pick One AA BA/BS MA/MS PhD	Pick One Prior to 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 After 2005

WORK EXPERIENCE: List all job-related experience in the space below, beginning with most current and ending with oldest employment. List name and address of employer and BRIEFLY describe your work experience. ALSO, be sure to include any Federal Government positions held with dates of employment and number of hours worked per week for each job. Your response must be limited to 4000 characters.

OTHER QUALIFICATIONS: List job-related skills (other languages, computer software/hardware); job-related training courses (give title and year); job-related honors, awards, and special accomplishments (publications, leadership activities, performance awards). Your response must be limited to 4000 characters.

ALL OFFICE AUTOMATION CLERK OR GENERAL OFFICE POSITIONS REQUIRE A MINIMUM WPM TYPING SKILL. PLEASE INDICATE YOUR WORD-PER-MINUTE SPEED OVER A FIVE MINUTE TIME PERIOD AND SHOW HOW MANY ERRORS.

I certify that I can type words per minute with no more than errors. My typing speed and error rates are based on typing performance for a period of 5 minutes.

Please provide your most current grade point average. GPA: Level: Pick One High School Undergraduate Master's PhD

Please list up to 40 classes you have taken (including those failed). List graduate courses first and undergraduate courses next. If you have taken any math or statistical courses please include on course listing. Credits should be totaled.

APPLICANT CERTIFICATION

In submitting this application I certify that, to the best of my knowledge and belief, all of the information on and attached to this application is true, correct, complete and made in good faith. I understand that false or fraudulent information on or attached to this application may be grounds for not hiring me or for firing me after I begin work, and may be punishable by fine or imprisonment. I understand that any information I give may be investigated.