ILSOS Applicant Identification Number - Please provide your IL Secretary of State issued Applicant ID #, if known.
First time applicants will be provided an Applicant ID # on the grade notice issued in response to this application. Please make note of this number for use on future applications.
County of Residence
Employment desired - check all that apply.
* Full Time Part Time Temporary
County Preference - Eligibility will be granted in the IL Counties/Cook County Zones where preference is indicated; up to three may be selected.
County Preference 1 *
County Preference 2
County Preference 3
Do you possess a valid driver's license?
* -- No answer -- Yes No
If Yes, DL State Issued by
If Yes, DL Class Rating
Please note: A copy of a certified college transcript/degree MUST be submitted to obtain credit for post high school educational achievement.
Highest Level of Education Completed? * -- No answer -- Eighth Grade or Less High School GED or Equivalent Technical/Vocational Certification Some College College - Associate College - Bachelor College - Master College - Doctorate Other
Major/Course of Study
Dates of Education
Attachment - Education Documents - Submit only once.
Are you fluent in language(s) other than English?
-- No answer -- Yes No
If Yes, provide details regarding language and fluency - speak/read/write
Are you currently a member of the Armed Services or National Guard/Reserves or a veteran of the U.S. military service?
To receive Veteran's Preference, submit a legible copy of a certified DD214/215, NGB22, U.S. Veterans Affairs award letter or letter from unit personnel indicating current service under honorable conditions. * -- No answer -- Yes No
Are you seeking Veteran's Preference on behalf of a veteran as a qualifying parent or spouse?
-- No answer -- Yes No
If Yes, indicate branch of service.
-- No answer -- Air Force Army Coast Guard Marines Navy Other
Date of Service - Entry
Date of Service - Discharge
Attachment - Veteran's Preference Documentation - Submit only once.
Do you have one or more family members employed by the Secretary of State?
Family members includes any person who has established a party to a civil union or parties to a marriage pursuant to the law. * -- No answer -- Yes No
If Yes, provide name and employing department for each.
Are you currently in default on the repayment of any educational loan?
State law requires an employee in default on repayment of any education loan for six months or more and in the amount of $600 or more shall, as a condition of employment, make satisfactory repayment arrangements with the maker or guarantor of the loan. * -- No answer -- Yes No
Have you ever been fired from a job? (Downsizing/Layoff does not apply)
* -- No answer -- Yes No
If Yes, please provide a detailed explanation - employer, dates, reason, etc.
Fully describe your work history beginning with your present position. It is important that you provide all requested information, dates of employment, hours worked per week, etc. If you held multiple positions with a single employee, list each position separately. Incomplete information may affect your ability to be considered. Additional work history or information may be provided as a single attachment.
Employer #1 - Name
Employer #1 - Address
Employer #1 - Telephone Number
Employer #1 - Job Title
Employer #1 - Dates of Employment
Employer #1 - Average Hours Worked per Week
Employer #1 - Job Duties
Employer #1 - Reason for Leaving
May we contact your current employer?
-- No answer -- Yes No
Previous Employer #2 - Name
Employer #2 - Address
Employer #2 - Telephone Number
Employer #2 - Job Title
Employer #2 - Dates of Employment
Employer #2 - Average Hours Worked per Week
Employer #2 - Job Duties
Employer #2 - Reason for Leaving
Previous Employer #3 - Name
Employer #3 - Address
Employer #3 - Telephone Number
Employer #3 - Job Title
Employer #3 - Dates of Employment
Employer #3 - Average Hours Worked per Week
Employer #3 - Job Duties
Employer #3 - Reason for Leaving
Previous Employer #4 - Name
Employer #4 - Address
Employer #4 - Telephone Number
Employer #4 - Job Title
Employer #4 - Dates of Employment
Employer #4 - Average Hours Worked per Week
Employer #4 - Job Duties
Employer #4 - Reason for Leaving
Attachment - Additional Job History/Information
Attachment - Other/Misc.
Child support obligations: State law requires that you provide certain information about child support obligations at the time of hire. The possibility of employment is not affected by a child support obligation or default in payment.
Selective Service Registration: As a condition of employment, state law requires that “every male born on or after January 1, 1960, and less than 27 years old, shall submit documentation, at time of appointment, evidencing his registration with the Federal Selective Service System.”
Disclosure of Information: The Office of the Secretary of State requests disclosure of information that is necessary to accomplish the statutory purpose as outlined under 15 ILCS 310/10. Disclosure of this information is REQUIRED; failure to provide any information may result in rejection of this form.
I confirm that have read and understood the Employment Information disclosed above. * -- No answer -- Yes
I certify that answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not, and is not intended to be a contract of employment.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge or other disciplinary action. I understand that if hired I authorize the State of Illinois to conduct an investigation into all aspects of my qualifications and background; any individual, organization, or agency that maintains records relating to me to provide these records upon request to any agency of the State Illinois conducting such an investigation. This authorization is not limited to employment records, credit records, and criminal history records. I release any individual, organization, or agency from any and all liability incurred as a result of providing such records. Proof of citizenship or immigration status will be required upon employment. * -- No answer -- Yes
The following questions are entirely optional.
To comply with government Equal Employment Opportunity and/or Affirmative Action reporting regulations, we are requesting (but NOT requiring) that you enter this personal data. This information will not be used in connection with any employment decisions, and will be used solely as permitted by state and federal law. Your voluntary cooperation would be appreciated.
Decline to answer Female Male
Decline to answer Hispanic or Latino White, not Hispanic or Latino Black or African-American, not Hispanic or Latino Asian, not Hispanic or Latino Native Hawaiian or Other Pacific Islander, not Hispanic or Latino American Indian or Alaskan Native, not Hispanic or Latino Two or More Races, not Hispanic or Latino
Invitation for Job Applicants to Self-Identify as a U.S. Veteran
A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
a person who was discharged or released from active duty because of a service-connected disability.
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Voluntary Self-Identification of Disability
Voluntary Self-Identification of Disability Form CC-305
OMB Control Number 1250-0005
We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified
people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we
must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability
or have ever had one. People can become disabled, so we need to ask this question at least every five years.
Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who
makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you
want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance
Programs (OFCCP) website at
A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had
such a condition, you are a person with a disability.
Disabilities include, but are not limited to:
Alcohol or other substance use
disorder (not currently using
Autoimmune disorder, for
example, lupus, fibromyalgia,
rheumatoid arthritis, HIV/AIDS
Blind or low vision
Cancer (past or present)
Cardiovascular or heart
Deaf or serious difficulty
Disfigurement, for example,
disfigurement caused by burns,
wounds, accidents, or congenital
Epilepsy or other seizure disorder
Gastrointestinal disorders, for example,
Crohn's Disease, irritable bowel
Intellectual or developmental disability
Mental health conditions, for example,
depression, bipolar disorder, anxiety
disorder, schizophrenia, PTSD
Missing limbs or partially missing limbs
Mobility impairment, benefiting from the
use of a wheelchair, scooter, walker,
leg brace(s) and/or other supports
Nervous system condition, for example,
migraine headaches, Parkinson’s
disease, multiple sclerosis (MS)
Neurodivergence, for example,
(ADHD), autism spectrum disorder,
dyslexia, dyspraxia, other learning
Partial or complete paralysis (any
Pulmonary or respiratory conditions, for
example, tuberculosis, asthma,
Short stature (dwarfism)
Traumatic brain injury
I consent to be contacted over SMS/Text for this job.