Virtual Virginia Virginia Department of Education James Monroe Building P. O. Box 2120 Richmond, Virginia 23219 EMPLOYMENT APPLICATION Date of Application: Date Available: An Equal Opportunity Employer Name: Last First Middle Street City State/Zip Street City State/Zip Present Address: Permanent Address: Primary Telephone: Email: EDUCATION List in chronological order all colleges or universities attended; include institution even if no degree was earned. Dates College/University To From Area of Study Degree Earned Date Conferred WORK EXPERIENCE List in chronological order beginning with most recent employer. Dates Employer Address Job Title From To Reason for Leaving REFERENCES Name Address Telephone