Form PD107 at a glance
What it is: Employment Application, State of North Carolina, PD107, revised 5.8.2026.
Who signs: SIGN with your Signature and Date.
A filled-in Form PD107 example: a first-time applicant fills page 1
How to fill out Form PD107, box by box
MY INFORMATION
Under MY INFORMATION, enter NAME (First Name, Last Name), PREFERRED NAME, ADDRESS (Street, City, State/Province, Zip Code), EMAIL ADDRESS, PHONE TYPE (Mobile/Landline), COUNTRY PHONE CODE, PHONE NUMBER and PHONE EXTENSION.
MY EXPERIENCE
Under MY EXPERIENCE, enter JOB TITLE, COMPANY, DATES (From/To) and ROLE DESCRIPTION, and I currently work here: Yes No.
EDUCATION
Under EDUCATION, enter SCHOOL OR UNIVERSITY NAME, SCHOOL TYPE (High School, College/University, Graduate/Professional or Other (Vocational/Internship)), DEGREE, FIELD OF STUDY, OVERALL RESULT (GPA) and DATES (From/To).
Certification and signature
"I certify that I have given true, accurate and complete information on this form to the best of my knowledge."
Yes No. SIGN: Signature, Date.
I authorize investigation of all statements made in this application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal action.
I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications (Authority: GS 126-30, GS 14-122.1).
I also understand that it is my responsibility to update my contact information should there be any changes in my name, address, phone number, or e-mail address.
More rules for Form PD107
Under CERTIFICATES AND LICENSES, enter CERTIFICATION and CERTIFICATION NUMBER, then ISSUE DATE and EXPIRATION DATE.
Attach copies of certification with job application.
Under SKILLS, enter SKILLS, then LANGUAGE and I AM FLUENT IN THIS LANGUAGE: Yes No, COMPREHENSION and OVERALL (Beginner, Intermediate, Advanced, Fluent), READING, WRITING and SPEAKING.
Attach resume/CV to email with job application.
In the Statewide Primary Questionnaire, 1. Are you legally authorized to work in the United States? Yes No 2. Will you now or in the future require sponsorship for employment visa status? Yes No
3. In addition to your application being considered for this position, your application may be reviewed by HR representatives at all state agencies for a period of 120 days for possible consideration for future vacancies within the same classification series. Do you want your application to be considered for future vacancies within the same classification series? Yes No
Even though your application may be reviewed for consideration, this does not guarantee you will be within the pool of most qualified applicants for any position, and the best way to ensure consideration for a particular position is to apply for that position.
4. For the jobs you listed in your work history, were any of the jobs less than 40 hours per week? Yes No. 5. If applicable, list each job that was less than 40 hours per week along with the number of hours per week. Include the employer, the position, and how many hours per week you worked.
6. Enter the last 4 digits of your social security number.
7. Are you currently employed by the State of North Carolina? Yes No. a. If so, indicate the agency/university for which you currently work.
8. Are you a layoff candidate with the State of North Carolina eligible for RIF priority reemployment consideration as described by GS 126? Yes No. a. Indicate your date of written notification.
9. Are you related by blood or marriage to any person now working for the State? Yes No. a. Provide their name, relationship to you, and the agency where employed.
10. If you are subject to Military Selective Service Registration, certify compliance by indicating: Subject to Military Selective Service and have complied, Subject to Military Selective Service and have not complied, or Not subject to Military Selective Service Registration.
11. Have you served honorably in the Armed Forces of the United States on active duty for reasons other than training? Yes No. 12. Do you wish to declare eligibility for Veteran's Preference? Yes No. a. If so, attach a copy of your DD-214.
13. Do you wish to declare eligibility for veterans' preference as the spouse of a disabled veteran? Yes No. 14. Do you wish to declare eligibility for veterans' preference as the surviving spouse or dependent of a deceased veteran who died for service-related reasons? Yes No. 15. Do you wish to declare eligibility for veterans' preference as a veteran or spouse of a veteran who suffered a service-connected disability? Yes No. a. If so, provide the entry and separation dates of your (or spouse's) qualifying active military service, branch of service, and rank.
16. Do you wish to declare eligibility for National Guard preference? Yes No. 17. Do you wish to declare eligibility for National Guard preference as a resident of North Carolina who is a current member in good standing of either the North Carolina Army National Guard or the North Carolina Air National Guard? Yes No. a. If so, attach a copy of the NGB 23A (RPAS). 18. Do you wish to declare eligibility for National Guard Preference and are a resident of North Carolina who is a former member of either the North Carolina Army National Guard or the North Carolina Air National Guard, whose discharge is under honorable conditions with a minimum of six years of creditable service? Yes No. a. If so, attach a copy of the DD256 or NGB 22.
In Equal Opportunity Information, the information requested will not affect you as an applicant and is not forwarded to the hiring manager. Answering the ethnicity question is optional.
Common questions about Form PD107
Where do I file it?
Apply to the department listed on posting.
Sources
[1] Form PD107, Employment Application (revised 5.8.2026), State of North Carolina (the Official source link on this page).
