state of west virginia - dodfire.comdodfire.com/jobs/231.pdf · of the west virginia air national...

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RWEST VIRGINIA MILITARY AUTHORITY 1703 COONSKIN DRVIE CHARLESTON, WEST VIRGINIA 25311-1085 O&M AGREEMENT POSITION VACANCY ANNOUNCEMENT ANNOUNCEMENT NUMBER: WVMA-ML171002 OPENING DATE: October 17, 2017 CLOSING DATE: October 31, 2017 LOCATION: Base Civil Engineering, 130 th Airlift Wing, Charleston, West Virginia JOB TITLE: Probationary Firefighter: This (Recruitment) will be used to establish a list of qualified candidates to fill the current vacancy and may be used to fill future vacancies as they occur over a fifteen month period. SALARY: Probationary Firefighter (3E731/51) Range $36,060 -$-$54,180 ANNUALLY MILITARY MEMBERSHIP: Position will be filled by a member of the West Virginia National Guard assigned to Fire Emergency Services; the individual must be/or become a member as condition of employment.xc GENERAL DESCRIPTION OF WORK: Individual performs firefighting, rescue, salvage, fire prevention and other fire protection operations for the protection operations of base facilities, equipment and personnel. MINIMUM MANDATORY CERTIFICATIONS: Fire fighter (AFSC 3E731/51: Required DOD Certification [Fire Fighter II, Airport Fire Fighter, HAZMAT Operations. HOW TO APPLY: Anyone interested in applying for this position must submit a completed State of West Virginia Application for Employment, resume and copies of required certifications to: West Virginia Military Authority, Attn. HR – Employment Application, 1703 Coonskin Drive, Charleston, WV 25311 or you may fax to 304-561-6321 or email to [email protected] All applications must be received by closing date. Applications may be obtained from the WVNG HRO web site: http://www.wv.ngb.army.mil/jobs/forms/default.html. SPECIAL REQUIREMENTS: 1. POSITION TO BE FILLED UPON AVAILABILITY OF RESOURCES. 2. POSITION IS CONTINGENT UPON RECEIPT OF CONTINUED DEPARTMENT OF DEFENSE FUNDING. 3. THIS POSITION FALLS UNDER THE WEST VIRGINIA PUBLIC EMPLOYEES RETIREMENT SYSTEM (PERS). 4. CONSIDERATION WILL BE GIVEN TO ALL QUALIFIED APPLICANTS WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, POLITICS, AGE, MEMBERSHIP OR NON-MEMBERSHIP IN AN EMPLOYEE ORGANIZATION. 5. STATE POSITIONS ANNOUNCED BY THE ADJUTANT GENERAL ARE AT-WILL EMPLOYMENT POSITIONS. THE TERM AT-WILL EMPLOYMENT MEANS THAT THE EMPLOYEE MAY BE TERMINATED AT ANY TIME WITHOUT CAUSE. 6. EMPLOYMENT SUBJECT TO FAVORABLE SECURITY AND BACKGROUND CHECK.

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Page 1: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

RWEST VIRGINIA MILITARY AUTHORITY 1703 COONSKIN DRVIE

CHARLESTON, WEST VIRGINIA 25311-1085 O&M AGREEMENT POSITION VACANCY ANNOUNCEMENT

ANNOUNCEMENT NUMBER: WVMA-ML171002

OPENING DATE: October 17, 2017 CLOSING DATE: October 31, 2017 LOCATION: Base Civil Engineering, 130th Airlift Wing, Charleston, West Virginia JOB TITLE: Probationary Firefighter: This (Recruitment) will be used to establish a list of qualified candidates to fill the current vacancy and may be used to fill future vacancies as they occur over a fifteen month period. SALARY: Probationary Firefighter (3E731/51) Range $36,060 -$-$54,180 ANNUALLY MILITARY MEMBERSHIP: Position will be filled by a member of the West Virginia National Guard assigned to Fire Emergency Services; the individual must be/or become a member as condition of employment.xc GENERAL DESCRIPTION OF WORK: Individual performs firefighting, rescue, salvage, fire prevention and other fire protection operations for the protection operations of base facilities, equipment and personnel. MINIMUM MANDATORY CERTIFICATIONS: Fire fighter (AFSC 3E731/51: Required DOD Certification [Fire Fighter II, Airport Fire Fighter, HAZMAT Operations.

HOW TO APPLY: Anyone interested in applying for this position must submit a completed State of West Virginia Application for Employment, resume and copies of required certifications to: West Virginia Military Authority, Attn. HR – Employment Application, 1703 Coonskin Drive, Charleston, WV 25311 or you may fax to 304-561-6321 or email to [email protected] All applications must be received by closing date. Applications may be obtained from the WVNG HRO web site: http://www.wv.ngb.army.mil/jobs/forms/default.html.

SPECIAL REQUIREMENTS:

1. POSITION TO BE FILLED UPON AVAILABILITY OF RESOURCES. 2. POSITION IS CONTINGENT UPON RECEIPT OF CONTINUED DEPARTMENT OF DEFENSE FUNDING. 3. THIS POSITION FALLS UNDER THE WEST VIRGINIA PUBLIC EMPLOYEES RETIREMENT SYSTEM (PERS). 4. CONSIDERATION WILL BE GIVEN TO ALL QUALIFIED APPLICANTS WITHOUT REGARD TO RACE, COLOR,

RELIGION, SEX, NATIONAL ORIGIN, POLITICS, AGE, MEMBERSHIP OR NON-MEMBERSHIP IN AN EMPLOYEE ORGANIZATION.

5. STATE POSITIONS ANNOUNCED BY THE ADJUTANT GENERAL ARE AT-WILL EMPLOYMENT POSITIONS. THE TERM AT-WILL EMPLOYMENT MEANS THAT THE EMPLOYEE MAY BE TERMINATED AT ANY TIME WITHOUT CAUSE.

6. EMPLOYMENT SUBJECT TO FAVORABLE SECURITY AND BACKGROUND CHECK.

Page 2: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

TITLE: PROBATIONARY FIREFIGHTER

PAY GRADE: TBD I. OCCUPATIONAL REQUIREMENTS: Incumbent subject to uncommon tours of duty, rotational shift

assignments. May be required to fly in military or civilian aircraft for TDY purposes. May be required to respond to requests for support from civilian fire departments.

II. INTRODUCTION: This position exists to provide fire protection and related services to personnel and resources

of the West Virginia Air National Guard, Yeager Airport Charleston, WV. Position is 100% federally funded and is considered mission essential. Due to the repetitive nature of normal duties, not knowing when emergency situations will arise, normal duties may not be completed at normally scheduled times. They are to be completed by 1600 hours of that duty day unless otherwise approved by the Assistant Fire Chief. Firefighters receive recurring proficiency training as directed by AFMAN 32-2003 and AFI 32-2001/ANG Supp. 1. Various training aids and manuals give firefighters adequate training. Work assignments are made on crew basis in rotation. Normal assignments are completed by the day of week, i.e., Monday-clean vehicles, Tuesday-bunkroom, etc.

III. The following duties, responsibilities and requirements constitute minimum requirements for this position. IV. DUTIES AND RESPONSIBILITIES:

Works scheduled 24-hour shifts in a variety of duties at the fire station and at the scene of an aircraft crash, fire or other emergency. a. Reports directly to the Crew Chief, Assistant Chief and/or Fire Chief.

b. Performs inspection and operator maintenance of firefighting vehicles, tools, equipment, protective

clothing, and maintains station facilities in a safe, efficient and timely manner following prescribed procedures. Missed scheduled maintenance and inspection procedures could affect performance rating negatively.

c. Drives and operates crash/fire rescue vehicles. Operates tools and equipment, controls and

extinguishes aerospace vehicle fires. Performs overhaul and salvage operations, airfield patrol surveillance, standbys and fuel spill cleanup. Assists in evacuation of personnel from buildings, protects exposures and positions and operates tools and equipment. Controls and extinguishes structural fires, loads hose and hose load finishes.

d. Perform building inspections and pre-fire planning; perform maintenance and testing of all building

Fire alarm systems, wet and dry pipe sprinkler systems, deluge systems and any other firefighting systems. These duties will be performed IAW prescribed regulations and procedures. Failure to perform the above will reflect negatively on performance evaluation.

e. Effects entry by normal and emergency means in aircraft and buildings, shuts down aircraft engines

and systems, performs rescue and administers emergency first aid and CPR if necessary. These duties will be performed efficiently and safely as possible. Failure to perform the above duties is considered unsatisfactory and will affect the performance rating negatively.

f. Participates in all training, classroom and practical, IAW current regulations and directives, and assists in evaluating training done by other firefighters. More than six missed training classes and/or drills will be considered unsatisfactory and will affect performance rating negatively.

g. Performs fire alarm and communications center duties. Alerts firefighting personnel and support

agencies, dispatches equipment, and inform personnel of location and nature of fires. Directs all incoming calls to appropriate personnel and takes messages. Will operate alarm room IAW AFI 32-2001/ANG Supp.1. Noncompliance with AFI 32-2001/ANG Supp. 1 will affect performance rating negatively.

Page 3: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

h. Strictly adhere to policies and regulations IAW the operating instructions of this Fire Department, The

State of West Virginia regulations and AFI 32-2001/ANG Supp. 1. Will conduct himself or herself in a professional manner at all times and maintain the proper attitude toward the position at all times. Will be on time for all shifts unless leave has been approved or the Assistant Fire Chief has approved the individual being late. Being late for roll call more than twice without approval during the rating period will be considered unsatisfactory and will affect the performance rating negatively.

i. Must acquire a working knowledge of regulations, directives, operating instructions and standards.

j. Must acquire a working knowledge of all mission related hazardous materials.

k. Must be able to make immediate decisions during emergency situations.

l. Other duties as assigned.

V. SUPERVISORY CONTROLS:

Reports to the Crew Chief or Assistant Chief for crew assignments.

VI. QUALIFICATIONS:

a. AGE REQUIREMENT: 1. Candidates must be at least age 18 at the time of this announcement. 2. Maximum age of 39 at the time of probationary appointment. (Industry standard is

usually 37) due to retirement qualifications.

b. MANDATORY:

1. Must have at least one year experience with military or organized civilian fire department. ANG/CEXF requires the following certifications: IFSAC or DoD certifications for Firefighter II, Airport Firefighter and HazMat Operations. With a knowledge of characteristics, range, and effectiveness of various extinguishing agents, combustible materials, fire alarm systems, first aid, firefighting apparatus and allied equipment, firefighting and rescue techniques, and other operations peculiar to crash/fire rescue. Must be/or must complete a State and National EMT-B course within 36 months of appointment and maintain then for continued employment.

2. Must submit to and pass, without exception, initial and annual occupational physicals in accordance with the current edition of NFPA 1582 (Medical Requirements for Firefighters). 3. Candidates will receive Psychological evaluations in accordance with the current edition of NFPA 1582 (Medical Requirements for Firefighters).

4. High school diploma or GED equivalent.

5. Qualified personnel are hired in accordance with department needs, State and Federal policy and Affirmative Action Plan.

6. Objectives are met on schedule and special projects are completed as required.

7. Must possess and maintain, at all times, a state and government vehicle operator’s license. Failure to do so could result in dismissal.

8. Must have a working knowledge of all assigned firefighting and rescue equipment.

Page 4: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

9. Must be familiar with egress and safety procedures of all assigned military and civilian aircraft.

10. Must be knowledgeable in operation of vehicles and radios around aircraft movement areas.

11. Must be willing to be tested for communicable diseases and illegal substance consumption. Positive results will result in instant dismissal.

12. 12 month probationary period. 13. Must complete all required training, to obtain skill level 3E751, i.e.… (CDC, or in residence). Within 12 months of appointment. 14. Must be/or must complete a State and National EMT-B course within 36 months of appointment and maintain then for continued employment.

15. Be a member of the WVANG Assigned to the Fire Emergency Services career field.

c. OCCUPATIONAL ASSESSMENT:

CARDIOVASCULAR ASSESSMENT 1. 1.5 mile run required to be completed within 13:00 minutes.

OCCUPATIONAL ASSESSMENT

The assessment component requires firefighters to complete ten simulated firefighting tasks on obstacle course (circuit) wearing Fitness Clothing with a 50 pound weight vest. In a consecutive manner without stopping. The ten tasks are as follows:

Task 1: One Arm Hose Carry. Carry one 50-ft section of 3-inch hose 100 feet.

Task 2: Ladder Raise. Carry a 12-ft ladder 50 feet and raise it against a wall Task 3: Charged Hose Drag. Drag a charged 1.5-1 ¾ inch hose 100 feet.

Task 4: First Ladder Climb. Climb a 24-ft ladder (10 rungs) three times.

Task 5: High Volume Hose Pull. Pull a section of 4.5 or 5-inch hose 100 feet hand over hand. Task 6: Forcible Entry. Move a 225lb tire 12 inches using a 10-lb Sledgehammer. Task 7: Victim Drag. Drag a mannequin weighing 150 pounds 100 feet. Task 8: Second Ladder Climb. Climb a 24-ft ladder (10 rungs) twice. Task 9: Ladder Lower. Lower a 12-ft ladder and carry it a distance of 50 feet. Task 10: Spreader Tool Carry. Carry an 80-lb spreader tool (Hurst Tool) 100 feet.

d. DESIRABLE:

1. Completion of a U.S. Air Force Fire Protection Course and have attained the U.S. Air Force

AFSC or equivalent.

2. Advanced training in the various facets of firefighting from a qualified IFSAC accredited school.

Page 5: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

APPLICATION FOR EMPLOYMENT

1703 Coonskin Drive ♦ Charleston, West Virginia 25311 ♦ PH: 304-561-6314

JOB CLASSES FOR WHICH YOU ARE APPLYING Application cannot be processed without at least one job title

1. 2. 3.

SOCIAL SECURITY NUMBER (See SSN note in instructions)

LAST NAME FIRST NAME MIDDLE INITIAL

STREET ADDRESS

CITY, STATE, and ZIP COUNTY OF RESIDENCE

HOME PHONE CELL PHONE EMAIL MARK ALL EMPLOYMENT TYPES YOU WILL ACCEPT ANSWER EACH OF THE FOLLOWING Y N A Permanent Full-Time May we contact you via email?

Have you applied to the Military Authority in the last 12 months?

B Permanent Part-Time C Temporary Part-Time

Have you applied to the Military Authority using a different full or last name? If yes, enter other name.

D Intermittent E Intern

MARK ALL SHIFTS YOU WILL ACCEPT A Day Shift

Have you previously held or do you currently hold a job covered by the Military Authority?

B Evening Shift C Night Shift D Rotating Shift

DATE AVAILABLE TO BEGIN WORK

Have you been convicted of a felony in the past seven years? Yes No

NOTE: A ‘yes’ answer will not cause your name to be removed from an employment register or bar you from all employment unless the conviction relates to the position for which you are applying.

Can you legally work in the U.S.? If temporarily, enter expiration date.

MILITARY SERVICE and VETERANS PREFERENCE POINTS: Completion of this section is voluntary; however you must do s e e e s e e e e s e s e

Five (5) points shall be added to e e e score for any person who meets the eligibility requirements. Five additional points may be awarded if you received a Purple Heart Award or if you have a verified compensable service-connected disability. Before completing this section, please read the Veterans Preference Eligibility Require-ments information in the applications instructions.

Yes No Are you claiming five Veterans Preference Points for service in the United States Armed Forces?Are you claiming an additional five Veterans Preference Points based on:: Yes No A Purple Heart Award? (If yes, the award must be stated on the DD214 Form).) Yes No A verified compensable service-connected disability? (If yes, a Veterans Administration

letter dated within the past six months is required – see instructions)

Announcement Number1.2.3.

West Virginia Military Authority

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Page 6: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

EMPLOYMENT HISTORY: List all work experience beginning with your present/most recent employer and work back. Changes in title, duties, or employment status with the same employer must be listed as separate jobs. Be sure to show employment dates and hours worked per week, and for paid work, you must list a salary. If more space is needed to describe your duties, feel free to attach additional pages. For more on this section, refer to the instruction pages. IMPORTANT: Resumés may be submitted in addition to the information provided on these pages.

EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER PHONE BUSINESS TYPE

SUPERVISOR’S NAME YOUR JOB TITLE LAST SALARY EMPLOYMENT DATES (month/year)

From To EMPLOYMENT STATUS HOURS WORKED

Paid Volunteer Full-Time Part-Time Hours Worked Per Week SUPERVISORY EXPERIENCE

Did you supervise employees? Yes No Date you began supervising (month/year)

List title(s) and number(s) of employees you officially supervised

DETAILED DESCRIPTION OF YOUR JOB DUTIES

EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER PHONE BUSINESS TYPE

SUPERVISOR’S NAME YOUR JOB TITLE LAST SALARY EMPLOYMENT DATES (month/year)

From To EMPLOYMENT STATUS HOURS WORKED

Paid Volunteer Full-Time Part-Time Hours Worked Per Week SUPERVISORY EXPERIENCE

Did you supervise employees? Yes No Date you began supervising (month/year)

List title(s) and number(s) of employees you officially supervised

DETAILED DESCRIPTION OF YOUR JOB DUTIES

West Virginia Military Authority

2

Page 7: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

EMPLOYMENT HISTORY: List all work experience beginning with your present/most recent employer and work back. Changes in title, duties, or employment status with the same employer must be listed as separate jobs. Be sure to show employment dates and hours worked per week, and for paid work, you must list a salary. If more space is needed to describe your duties, feel free to attach additional pages. For more on this section, refer to the instruction pages. IMPORTANT: Resumés may be submitted in addition to the information provided on these pages.

EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER PHONE BUSINESS TYPE

SUPERVISOR’S NAME YOUR JOB TITLE LAST SALARY EMPLOYMENT DATES (month/year)

From To EMPLOYMENT STATUS HOURS WORKED

Paid Volunteer Full-Time Part-Time Hours Worked Per Week SUPERVISORY EXPERIENCE

Did you supervise employees? Yes No Date you began supervising (month/year)

List title(s) and number(s) of employees you officially supervised

DETAILED DESCRIPTION OF YOUR JOB DUTIES

EMPLOYER NAME EMPLOYER ADDRESS EMPLOYER PHONE BUSINESS TYPE

SUPERVISOR’S NAME YOUR JOB TITLE LAST SALARY EMPLOYMENT DATES (month/year)

From To EMPLOYMENT STATUS HOURS WORKED

Paid Volunteer Full-Time Part-Time Hours Worked Per Week SUPERVISORY EXPERIENCE

Did you supervise employees? Yes No Date you began supervising (month/year)

List title(s) and number(s) of employees you officially supervised

DETAILED DESCRIPTION OF YOUR JOB DUTIES

West Virginia Military Authority

3

Page 8: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

EDUCATION: If you need additional space, provide the information on a separate sheet of paper.

Did you receive a high school diploma or GED equivalent? High School Diploma GED Equivalent Neither

Mark highest grade completed: 1 2 3 4 5 6 7 8 9 10 11 12

Additional Education: All academic training other than High School/GED Equivalent must be verified. Verification of academic training may be in the form of an official transcript, copy of diploma or certificate, or written statement from an authorized agency verifying possession of the necessary credentials.

SCHOOL NAME and ADDRESS

FIELD(S) of STUDY CREDIT HOURS ATTENDANCE DATES TYPE OF

DEGREE ATTACH

TRANSCRIPT major minor sem. qtr. mo./yr. mo./yr.

BUSINESS/VOCATIONAL/ TECHNICAL SCHOOL COURSE(S) of STUDY NO. WEEKS

ATTENDED HOURS

PER DAY CLOCK HRS. COMPLETED

CERTIFICATE ATTACH COPY

AFFIRMATION: I certify under penalty of law and disqualification that all statements are true and complete. I authorize the State of West Virginia and any agent acting on its behalf to conduct an inquiry into any job-related information contained in this application. I release the State of West Virginia and any agent acting on its behalf from any and all liability by reason of the request for such information. I further authorize and request each former employer educational institution, or organization (including law enforcement agencies) to provide all information that may be sought in connection with this application.

Yes No If you are a male, age 18-25, have you registered, as required, with the U.S. Selective Service?

SIGNATURE: _____________________________________________________ DATE: ___________________________

I would submit to drug testing if required. Yes No

REFERENCES: Please provide three personal references that we may contact.

NAME ADDRESS PHONE

Do you have family members/relatives that are currently employed by the West Virginia Military Authority or the West Virginia National Guard? Yes No If yes, please list their names in the box below.

West Virginia Military Authority

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Page 9: STATE OF WEST VIRGINIA - DodFire.Comdodfire.com/JOBS/231.pdf · of the West Virginia Air National Guard, Yeager Airport Charleston, ... accordance with the current edition of NFPA

EQUAL EMPLOYMENTOPPORTUNITY QUESTIONNAIRE

The following information will be used solely to evaluate recruitment and examination methods. This form will be kept separate from your application and will not be shared with hiring agencies. Nothing you write on this form will in any way affect your test score or your chances for employment. Answering these questions is voluntary; however, your cooperation is essential for us to ensure equal employment opportunity for all job applicants. Enter the information below as indicated. Please enter only one number or mark per block – do not use dashes or other punctuation or symbols.

SOCIAL SECURITY NUMBER DATE of BIRTH GENDER only one number per block EX: June 25, 1977 would be 0 6 2 5 7 7 MALE FEMALE

GGGGGGGGG GG GG GG G G DISABILITY INFORMATION: A disabled individual is any person who:

• has a disability which substantially limits one or more of the major life activities,• has a record of such impairment, and/or• is regarded as having such an impairment.

Yes No Do you have a qualifying disability?

RACIAL/ETHNIC BACKGROUND: Please mark the item which best describes your PRIMARY racial/ethnicbackground. Mark only one item.

BLACK – A person having origins in one of the black racial groups of Africa.

HISPANIC – A person of Mexican, Puerto Rican, Cuban, Central American, South American, or other Spanishculture or origin, regardless of race.

WHITE – A person having origins in any of the original people of Europe, North Africa, or the Middle East.

AMERICAN INDIAN or ALASKAN NATIVE – A person having origins in any of the original people of North Americaand who maintains cultural identification through tribal affiliation or community recognition.

ASIAN or PACIFIC ISLANDER – A person having origins in any of the original people of the Far East, SoutheastAsia, the Indian subcontinent, or any of the Pacific Islands. Some examples include China, India, Japan, Korea,the Philippine Islands, Pakistan, Vietnam, Hawaii, Guam, and Samoa.

SOURCE(S) of INFORMATION: Mark up to four sources of information below in rank of importance. Mark yourmost important sources with a ‘1’, your second most important sources with a ‘2’, and so on. Rank at least one source, but not more than four.

G A) DOP Counselor G E) Div. of Human Services G I) RadioAnnouncement G M) State Agency

Referral

G B) DOP InformationBooklet G F) High School Counselor

or Teacher G J) Newpaper G N) DOP WebsiteInformation

G C) DOP RecruiterInformation G G) College Placement

Office or Advisor G K) Friend/Neighbor G O) Other (explain)

G D) WorkForce WVor Job Serv. Off. G H) State Vocational

Rehabilitation Office G L) State Employee G P) Other (explain)

West Virginia Military Authority

5

OPTIONAL