Cms100 Application Form PDF Details

The CMS 100 application is now available on the College of Charleston website. This form is for students who are interested in majoring in advertising, graphic design, marketing or public relations. The deadline to submit the CMS 100 form is February 1st. Students who are accepted into one of these programs will be notified by March 15th. For more information on the CMS 100 application process, please visit the College of Charleston website. Thank you for your interest in our programs!

Question	Answer
Form Name	Cms100 Application Form
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	cms 100 employment application, illinois cms100, cms100 No Download Needed, cms 100 application 2021

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EXAMINING/EMPLOYMENT APPLICATION (CMS100)

CMS administers civil service testing for agencies under the jurisdiction of the Governor; however, actual employment decisions are made by the hiring agencies. Pencil copies of applications will not be accepted. Legible photocopies are accepted.

PLEASE PRINT LEGIBLY OR TYPE INFORMATION.

POSITION TITLE

OPTION

LEAVE BLANK

LAST NAME

FIRST NAME

3. SOCIAL SECURITY NUMBER

MAILING ADDRESS

COUNTY

4. BIRTHDATE (OPTIONAL)

CITY

STATE

ZIP CODE

5. HOME TELEPHONE

OTHER TELEPHONE

(

)

(

)

DRIVERS LICENSE NUMBER

STATE

MO/YR EXPIRES

RESTRICTIONS

NON-CDL

CDL

ENDR

A B C D L M

A B

X N

COUNTY CHOICE

COUNTY

COOK/ZONE

LEAVE BLANK

COUNTY

COOK/ZONE

LEAVE BLANK

(Select one or two)

8. AVAILABILITY	A.
(Check one)

Available for permanent employment;	B.
will not accept temporary employment.
(Trainee titles must choose A.)

Available for permanent employment;	C.
will accept temporary employment.

Available for temporary employment only.

9. If your answer to any of the following questions is “yes” please attach a signed, detailed explanation.		YES
A. Have you ever been fired from a job? (Downsize/layoff is not applicable.)		YES

B. Have you ever pled guilty to or been convicted of any criminal offense other than a minor traffic violation?			YES
Pursuant to Public Act 93-0211, effective January 1, 2004, (20 ILCS 2630/12 (a)) and Public Act 93-0912,
effective August 12, 2004,	(705 ILCS 405/5-915 (8a)), respectively, applicants seeking employment with the State
of Illinois are not obligated to disclose an arrest or conviction record that has been expunged or sealed, nor an
expunged juvenile record.	Employers may not ask if an applicant has had records expunged or sealed.	Neither

Public Act applies to law enforcement agencies, the Department of Corrections, State’s Attorneys or other prosecutors.

C. Are you currently in default on the repayment of any state educational loan?

YES

State law provides that any employee who is in default on the repayment of any education loan for a period of six months or more and in the amount of $600 or more shall, as a condition of employment, make a satisfactory loan repayment arrangement with the maker or guarantor of the loan.

10. VETERANS PREFERENCE: For assistance contact Veterans Outreach at 1-800-643-8138		or Illinois Relay Center
	at 1-800-526-0844 (TTY only).
	I wish to claim Veterans Preference; attached is the most recent certified copy of my DD214/215.	(If claiming service-connected
		(If claiming service-connected
	disability, also include a copy of U.S. Veterans Affairs award letter.)

I wish to claim Veterans Preference as an IL National Guard/Reservist. Attached is a letter from my unit personnel indicating I am currently serving under honorable conditions or a copy of my NGB22 stating my discharge was under honorable conditions.

I wish to claim Veterans Preference as a surviving unremarried spouse or one parent of an unmarried veteran who suffered a service- connected death or disability that prevents the veteran from qualifying for civil service employment.

I have submitted required military documentation to CMS after January 01, 2000 and have already established Veterans Preference with CMS.

LEAVE BLANK

11.

HIGH SCHOOL GRADUATE

YES

NUMBER OF YRS COMPLETED

0 1 2 3 4

GED

YES

12.

BUSINESS, TRADE, CORRESPONDENCE

FROM

TIME

SUBJECTS

COURSE

COMPLETED

SCHOOL: NAME AND ADDRESS

FULL

PART

LENGTH

YES

13. TECHNICAL/PROFESSIONAL LICENSE

NUMBER

STATE ISSUED

DATE ISSUED

MO YR

EXPIRATION DATE

MO YR

CMS 100 (Rev. 03/12) Printed on Recycled Paper

FOR CMS USE ONLY

EXAM DATE

TEST CENTER

MONTH DAY YEAR

14.EDUCATION REPORT: LIST YOUR EDUCATION ACCURATELY AND COMPLETELY. A copy of college transcripts/degrees may be required. The number of credit hours you have earned may be needed to meet the minimum requirements for some titles. This information is also useful for career counseling purposes.

NAME AND ADDRESS OF

HOURS

MAJOR

MINOR

DATES ATTENDED

LEVEL AND DATE OF

COLLEGES/UNIVERSITIES ATTENDED

EARNED

(DO NOT

FROM

DEGREE EARNED

SEM

QTR

ABBREVIATE)

MO/YR

LEVEL

Undergraduate:

Graduate:

LIST UNDERGRADUATE AND

INDICATE THE ACTUAL NUMBER OF

DO NOT INCLUDE COURSES

GRADUATE HOURS SEPARATELY

SEMESTER OR QUARTER HOURS EARNED

MORE THAN ONCE

FIELDS OF STUDY

UNDERGRADUATE

GRADUATE

FIELDS OF STUDY

UNDERGRADUATE

GRADUATE

LIST ACTUAL

# OF

LIST ACTUAL

# OF

CREDIT HOURS

SEM HRS

QTR HRS

SEM HRS

QTR HRS

CREDIT HOURS

SEM HRS

QTR HRS

SEM HRS

QTR HRS

Accounting

Humanities

Actuarial Science

Human Services

Afro-American Studies

Hydrology

Agriculture

Industrial Arts

Agronomy

Industrial Hygiene

Animal Science

Insurance

Architecture

Journalism

Art

Law (specify)

Atmospheric Science

Law Enforcement

Audiovisual Instruction

Library Science

Bacteriology

Limnology

Biochemistry

Mgmt Info Systems

Biology

Marketing

Biostatistics

Mathematics

Botany

Medical Records

Business Admin/Mgmt

Medical Technology

Cell/Molecular Biology

Medicine

Chemistry

Microbiology

Computer Science

Nursing (specify)

Conservation

Park Management

Criminal Justice Admin

Pastoral Counseling

Criminology

Pharmacy

Demography

Physics

Dietetics, Nutrition

Political Science/Govt

Divinity/Theology

Programming

Early Childhood Development

Psychology

Economics

Public Administration

Education (specify)

Radio-Television

Engineering (specify)

Recreation

Engineering Technology

Rehab Counseling/Admin

Environmental Science

Risk Assessment

English

Secretarial Science

Entomology

Social Work

Environmental Health

Sociology

Epidemiology

Soil Science

Finance

Speech and Drama

Fire Science

Statistics

Fish Management

Therapy (specify)

Food Service Mgmt

Toxicology

Foreign Language (specify)

Urban Studies

Forensic Science

Wildlife Management

Forestry

Zoology

Geography

Other:

Geology

Genetics

Guidance and Counseling

Health/Public Health

History

Home Economics

Attach separate sheet of paper for additional coursework if necessary.

15.WORK HISTORY: Complete this section in detail. All fields MUST be completed to be considered for grading. Begin with most recent position title and work backward. If you have an extensive work history with one employer, list each change in position title separately including duties and dates associated with each. Unsigned or incomplete applications will be returned. If additional space is needed, attach a separate sheet following the same format as below. Resumes submitted must be in same format as the application. Place additional sheets/resumes inside the application.

INCLUDE THE FOLLOWING INFORMATION:

•College internships/practicums successfully completed

•Military experience including dates, listing each change in rank and title

•Related volunteer experience including dates and hours worked

CURRENT (OR LAST) EMPLOYER

POSITION TITLE

STREET ADDRESS

AVERAGE # OF HOURS WORKED PER WEEK

CURRENT OR LAST SALARY

FULL-TIME

PART- TIME

WEEKLY OR MONTHLY OR ANNUALLY

CITY

STATE

DATES OF EMPLOYMENT

TOTAL

MONTH

YEAR

MONTH

YEAR

YEARS

MONTHS

SUPERVISORY RESPONSIBILITY:

MANUAL/TRADES

CLERICAL

TECHNICAL/PARA-

PROFESSIONAL

ADMINISTRATIVE

LIST THE NUMBER OF EMPLOYEES YOU

PROFESSIONAL

SUPERVISED IN THE APPROPRIATE BOX(ES)

DESCRIBE DUTIES AND RESPONSIBILITIES FOR EACH POSITION TITLE SEPARATELY:

REASON FOR LEAVING:

EMPLOYER

POSITION TITLE

STREET ADDRESS

AVERAGE # OF HOURS WORKED PER WEEK

CURRENT OR LAST SALARY

FULL-TIME

PART- TIME

WEEKLY OR MONTHLY OR ANNUALLY

CITY

STATE

DATES OF EMPLOYMENT

TOTAL

MONTH

YEAR

MONTH

YEAR

YEARS

MONTHS

SUPERVISORY RESPONSIBILITY:

MANUAL/TRADES

CLERICAL

TECHNICAL/PARA-

PROFESSIONAL

ADMINISTRATIVE

LIST THE NUMBER OF EMPLOYEES YOU

PROFESSIONAL

SUPERVISED IN THE APPROPRIATE BOX(ES)

DESCRIBE DUTIES AND RESPONSIBILITIES FOR EACH POSITION TITLE SEPARATELY:

REASON FOR LEAVING:

EMPLOYER

POSITION TITLE

STREET ADDRESS

AVERAGE # OF HOURS WORKED PER WEEK

CURRENT OR LAST SALARY

FULL-TIME

PART- TIME

WEEKLY OR MONTHLY OR ANNUALLY

CITY

STATE

DATES OF EMPLOYMENT

TOTAL

MONTH

YEAR

MONTH

YEAR

YEARS

MONTHS

SUPERVISORY RESPONSIBILITY:

MANUAL/TRADES

CLERICAL

TECHNICAL/PARA-

PROFESSIONAL

ADMINISTRATIVE

LIST THE NUMBER OF EMPLOYEES YOU

PROFESSIONAL

SUPERVISED IN THE APPROPRIATE BOX(ES)

DESCRIBE DUTIES AND RESPONSIBILITIES FOR EACH POSITION TITLE SEPARATELY:

REASON FOR LEAVING:

EMPLOYER

POSITION TITLE

STREET ADDRESS

AVERAGE # OF HOURS WORKED PER WEEK

CURRENT OR LAST SALARY

FULL-TIME

PART- TIME

WEEKLY OR MONTHLY OR ANNUALLY

CITY

STATE

DATES OF EMPLOYMENT

TOTAL

MONTH

YEAR

MONTH

YEAR

YEARS

MONTHS

SUPERVISORY RESPONSIBILITY:

MANUAL/TRADES

CLERICAL

TECHNICAL/PARA-

PROFESSIONAL

ADMINISTRATIVE

LIST THE NUMBER OF EMPLOYEES YOU

PROFESSIONAL

SUPERVISED IN THE APPROPRIATE BOX(ES)

DESCRIBE DUTIES AND RESPONSIBILITIES FOR EACH POSITION TITLE SEPARATELY:

REASON FOR LEAVING:

EMPLOYER

POSITION TITLE

STREET ADDRESS

AVERAGE # OF HOURS WORKED PER WEEK

CURRENT OR LAST SALARY

FULL-TIME

PART- TIME

WEEKLY OR MONTHLY OR ANNUALLY

CITY

STATE

DATES OF EMPLOYMENT

TOTAL

MONTH

YEAR

MONTH

YEAR

YEARS

MONTHS

SUPERVISORY RESPONSIBILITY:

MANUAL/TRADES

CLERICAL

TECHNICAL/PARA-

PROFESSIONAL

ADMINISTRATIVE

LIST THE NUMBER OF EMPLOYEES YOU

PROFESSIONAL

SUPERVISED IN THE APPROPRIATE BOX(ES)

DESCRIBE DUTIES AND RESPONSIBILITIES FOR EACH POSITION TITLE SEPARATELY:

REASON FOR LEAVING:

•State law requires that you furnish certain information about your child support obligations at the time you are hired. The possibility of employment is not affected by a child support obligation or default in payment.

•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.”

•In compliance with the state and federal constitutions, the Illinois Human Rights Act, the U.S. Civil Rights Act, the Americans with Disabilities Act, and Section 504 of the Federal Rehabilitation Act, the Department of Central Management Services does not discriminate in employment, contracts, or any other activity. If you have a complaint, please contact the Department of Central Management Services at 217/782-7100 (voice) or 800/526-0844 (TTY Only).

16.This application may be utilized as the actual test for some titles. If the title for which you wish to test is a closed exam or an exam based only on training and experience, mail completed application to: Central Management Services, Examining and Counseling, Room 500, Stratton Office Building, 401 South Spring Street, Springfield, Illinois 62706. Applications for a closed exam will be maintained until an agency requests that the test be administered or for a maximum of one year.

17.I understand that I may be required to submit proof of previous employment, education, military service or other statements in this application. I authorize release of this and other information covering job-related factors for the purpose of verification and determination of suitability for state employment. I state that I have not submitted an application for this written and/or performance examination within the last 30 days. I certify that the information on this application is true and accurate and understand that misrepresentation of any material fact may be grounds for ineligibility or termination of employment.

18.Completing this application may result in your name being placed on an eligibility list. Names placed on an eligibility list may be released to the public without further notice to the applicant.

DATE

WRITTEN SIGNATURE REQUIRED

The State of Illinois is an Equal Opportunity Employer. To assist in the accomplishment of Affirmative Action goals, we invite you to complete the following information. Completion of this information is not required. Circle ONE letter and, if applicable, check the appropriate box.

FEMALE	MALE
A	G	White not of Hispanic Origin. A person having origins in any of the original peoples
		of Europe, North Africa or the Middle East.
B	H	Black or African American not of Hispanic Origin. A person having origins in any
		of the black racial groups of Africa. Terms such as “Haitian” or “Negro” can also be
		used in addition to “Black” or “African American”.
C	J	American Indian orAlaska Native. Aperson having origins in any of the original
		peoples of North and South America, including Central America, and who maintains
		tribal affiliation or community attachment.
D	K	Asian. A person having origins in any of the original peoples of the Far East,
		Southeast Asia, or the Indian subcontinent, including, but not limited to, Cambodia,
		China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and
		Vietnam.
E	L	Hispanic or Latino. Aperson of Cuban, Mexican, Puerto Rican, South or Central
		American, or other Spanish Culture or origin, regardless of race.
P	Q	Native Hawaiian or Other Pacific Islander. Aperson having origins in any of the
		original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

DISABILITY

Yes

APPLICANT INFORMATION CONCERNING COOK COUNTY ZONES

Cook County is divided into five zones for the position titles listed below for the purpose of administering eligible lists. To explain the zones, the map is an outline of Cook County with the central and northern portions of the City of Chicago shown crosshatched. A more detailed map is available on our website at http://www.cms.illinois.gov under Employment, Frequently Asked Questions.

The open competitive position titles to which Cook County zones apply are:
Automotive Mechanic	Highway Maintainer Lead Worker	Office Clerk
Child Development Aide III	Laborer (Maintenance)	Security Officer
Cook I	Licensed Practical Nurse I and II	Stores Clerk
Heavy Construction Equip Operator	Office Aide	Storekeeper I
Highway Maintainer	Office Assistant	Support Service Worker

•Zone 1 is the area within the city limits of Chicago between North Avenue and 95th Street.

•

Zone 2 is the area within the city limits of Chicago north of North Avenue.

Zone 3 is Cook County and the area including the City of Chicago which is south of 95th Street.

Zone 4 is Cook County outside the City of Chicago between North Avenue and 95th Street.

Zone 5 is Cook County outside the City of Chicago north of North Avenue.

STATE OF ILLINOIS ASSESSMENT CENTERS

CHAMPAIGN (by appointment only)	ROCKFORD (by appointment only)	MARION (by appointment only)
Central Management Services	Central Management Services	Central Management Services
State Regional Office Building	E. J. “Zeke” Giorgi Center	State Regional Office Building
2125 South First Street	200 South Wyman Street	2309 West Main Street, Suite 126
Champaign, Illinois 61820	Rockford, Illinois 61101	Marion, Illinois 62959
Phone: 217-278-3435	Phone: 815-987-7004	Phone: 618-993-7005
Illinois Relay Center:	Illinois Relay Center:	Illinois Relay Center:
800-526-0844 (TTY only)	800-526-0844 (TTY only)	800-526-0844 (TTY only)

CHICAGO	SPRINGFIELD
Central Managment Services	Central Management Services
James R. Thompson Center - Suite 3-300	Capital City Center
100 W. Randolph Street	130 West Mason Street
Chicago, Illinois 60601	Springfield, IL 62702
Phone: 312-793-3565	Phone: 217-557-6885
312-814-4458 (TTY only)	217-524-1383 (TTY only)

Walk in test centers are located in Springfield and Chicago. Office hours are Monday-Friday 8 a.m. - 5 p.m.

Chicago and Springfield multiple choice automated testing is held Monday, Tuesday, Wednesday and Thursday. Check in time for clerical and non-clerical tests is anytime between 8 a.m. and 1:30 p.m. in Chicago and 8 a.m. and 2 p.m. in Springfield. You must arrive and be ready to test no later than 12:30 p.m. for Data Processing Administrative Specialist, Data Processing Specialist, HR Assistant, HR Associate, Insurance Analyst II, Revenue Tax Specialist Trainee, Telecommunicator Trainee and Dictation exams.

IDENTIFICATION IS REQUIRED AT THE TIME OF TESTING AT ALL ASSESSMENT CENTERS.

Visit our website for more information at http://work.illinois.gov

or for general information regarding testing and career counseling contact

CMS Examining and Counseling Division, Room 500 Stratton Building, Springfield, IL 62706

(217) 782-7100 (voice) (800) 526-0844 (TTY Only)

Career Services Career counselors are available at all of the assessment center locations by appointment only. A completed CMS application is required at the time of the appointment for review by the counselor. After reviewing your completed application and discussing your education and work experiences, the counselor will recommend job titles and provide descriptions of the job requirements. Call in advance to make an appointment. Phone numbers are listed above for the specific locations.

Testing Information There are approximately 950 position titles used by the state agencies under the jurisdiction of the Governor. To be considered as an eligible applicant for one of these titles, the applicant must participate in either an automated multiple-choice test (AT); or submit the application for a review of the training and experience (TX) listed on the application. A grade is given for each of these exam types. The position titles are separated into Group A and Group B.

Group A - titles are tested for continuously. The Group A titles requiring an automated multiple-choice exam (AT) are administered at any of the assessment centers listed above. The Group A titles requiring review of the applicant’s training and experience (TX) should be sent to CMS, Examining and Counseling Division, Room 500 Stratton Office Building, Springfield, IL, 62706, for grading.

Group B - titles are closed exams. Send applications for any Group B title to CMS, Examining and Counseling Division, Room 500 Stratton Office Building, Springfield, IL, 62706. Applications for a Group B closed exam will be maintained until an agency requests that the test be administered or for a maximum of one year.

•Information on the position titles may be obtained from any Assessment Center or by viewing the Web site.

•NOTE: A separate application is usually required for each title and option for which you test. Some exceptions: You may use one application to apply for a TX grade for multiple options for Public Service Administrator (PSA) and Senior Public Service Administrator (SPSA). Use one application for all selected options for each title for the Information Services Specialist (ISS) and the Information Systems Analyst (ISA).

•Many AT tests in the same series require only one application. Check with any assessment center for details.

Veterans Preference is awarded to veterans after CMS receives appropriate documentation and verifies eligibility. For more information contact the Veterans Outreach Office at 800-643-8138; Illinois Relay Center 800-526-0844 (TTY only).

Highway Maintainer Examination requires the possession of a valid commercial drivers license, Class “A,” with endorsements of “N” (Tankers) or “X” (Tankers with hazardous materials) and non-restrictive air brakes, before an applicant can participate in the examination.

Automotive Mechanic Examination (All Options) and Maintenance Equipment Operator Examination require the possession of a valid Class “A” or “B” commercial drivers license before an applicant can participate in the examination.

If you are an individual with a disability and need accommodated testing assistance, please contact the Disabled Workers Program in Springfield at (217) 524-7514 (voice) or (217) 524-1383 (TTY only) before the date of the test.

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