First Name*
Last Name*
Email Address*
Phone*
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 notice issued in response to this application. Please make note of this number for use on future applications.
Middle Initial
County of Residence*
Employment desired - check all that apply.*
Full Time Part Time Temporary
Title Applied For*
County Preference - Eligibility will be granted in the IL Counties/Cook County Zones where preference is indicated; up to three may be selected.
Cook County Zones are only applicable to the titles of Public Service Clerk, Public Service Representative, Motor Vehicle Cashier and their Intermittent counterparts. Information identifying which zone represents each facility is available on the Secretary of State website.
County/Zone Preference 1*
County/Zone Preference 2
County/Zone 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
Education Report:
Please note: For Training and Experience evaluated titles, 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
College/University Information
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 a member of the National Guard/Reserves or a veteran of the U.S. military service?*
-- No answer -- Yes No
Will you be seeking Veteran's Preference on behalf of a veteran as a qualifying parent or spouse?
-- No answer -- Yes
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 - Veterans 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.
Experience Report:
Fully describe your work history beginning with your present position. 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.
Previous Employer #1 - Name
Employer #1 - Address
Employer #1 - Telephone Number
Employer #1 - Job Title
Employer #1 - Dates of Employment
Employer #1 - Avg. 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 - Avg. 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 - Avg. 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 - Avg. Hours Worked per Week.
Employer #4 - Job Duties
Employer #4 - Reason for Leaving
Attachment - Additional Job History Information (Optional)
Attachment #4 - Other (Optional)
Employment Information:
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
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
Expires 04/30/2026
Why are you being asked to complete this form?
How do you know if you have a disability?
I consent to be contacted over SMS/Text for this job.