Associated health trainee checklist - without compensation (woc) | veterans affairs

(PLEASE DOWNLOAD EACH DOCUMENT TO YOUR COMPUTER TO EDIT AND INPUT YOUR INFORMATION.)  MAILING ADDRESS: Durham VA Medical Center [insert mail code from Point of Contact document] Attn:

[insert name of DVAHCS point of contact from the Point of Contact document] 508 Fulton Street Durham, North Carolina 27705  VA FORM 10-2850D APPLICATION FOR HEALTH PROFESSIONS TRAINEE DATED

NOV 2011  (Provide FIRST, FULL MIDDLE, & LAST NAME). If you don’t have a middle name, indicate “No Middle Name”.  If you have only initials in your name, provide them and indicate

“Initial only”.  (Please provide your complete name & SSN at top of Pages 2-4. Sign pages 3 & 4. Return this document to your DVAHCS POC) FORM (OF) 306, DECLARATION FOR FEDERAL

EMPLOYMENT - REVISED OCTOBER 2011 (Provide (FIRST, FULL MIDDLE, & LAST NAME). If you don’t have a middle name, indicate “No Middle Name”. If you have only initials in your name, provide

them and indicate “Initial only”.  (Sign page 3.  Return this document to your DVAHCS POC)   SELECTIVE SERVICE SYSTEM: * Male trainees are required to visit https://www.sss.gov to register,

print proof of registration or, if not registered, apply for a status information letter (SIL). The SIL denotes one’s requirement for registration, and, if applicable, exemption from the

registration requirement. (PROVIDE A COPY OF THIS DOCUMENTATION TO YOUR DVAHCS POC) * Federal law requires that most males living in the US between the ages of 18 and 26 register with the

Selective Service System. This includes individuals who are US citizens, non-US citizens and dual nationals, regardless of their immigration status. Male for this purpose is defined as those

individuals born male on their birth certificate regardless of current gender. Only male, non-US citizens on a student or visitor visa are exempt from registration. * Complete a request

form for a status information letter at the gov website. You will have to describe, in detail, the circumstances you believe prevented you from registering and provide copies of documents

showing any periods when you were hospitalized, institutionalized, or incarcerated occurring between your 18th and 26th birthdays. If you are a non-citizen, you may be required to provide

documents that show when you entered the United States. Please include your name, social security number, date of birth, and return address. * Males required to register, but who fail to do

so by their 26th birthday, are BARRED FROM ANY POSITION IN ANY EXECUTIVE AGENCY. * FOR MEN BORN AFTER 1960: A status information letter from the Selective Service System states the facts: 

Whether or not the man is registered; whether or not the man should have registered or if he is exempt. * If you did not register with Selective Service and are now a man 26 years old or

older, you may be ineligible for certain federal or state programs and benefits, including U.S. citizenship. Some agencies may ask you to provide an official response from the Selective

Service indicating if you were or were not required to register.    Locations for courtesy fingerprints can be found at: HTTP://WWW.VA.GOV/PIVPROJECT/PIV_BADGE_OFFICES.ASP. Advise your

DVAHCS POC when courtesy prints were taken.   VHA MANDATORY TRAINING FOR TRAINEES (MTT): MUST BE COMPLETED PRIOR TO SUBMITTING PAPERWORK  Go to TMS website, Self register and complete MTT.

You need the following information to complete self-registration: VA Location: DUR  *TRAINEES WHO PREVIOUSLY HAD TMS ACCOUNTS: CHANGE YOUR EMAIL ACCOUNTS IN TMS TO ENSURE YOU CAN ACCESS THE

EMAIL ACCOUNT LISTED.  IF YOU PREVIOUSLY HAD A TMS ACCOUNT AND CAN NO LONGER ACCESS IT, PLEASE CALL THE DURHAM VA TMS DOMAIN MANAGERS AT 919.286.0411 EXT 176909 FOR ASSISTANCE. DVAHCS POC: 

OPEN THE POC LINK BELOW TO IDENTIFY YOUR POC. ENTER THEIR NAME HERE PROVIDE YOUR POC A COPY OF YOUR COURSE COMPLETION PERSONAL IDENTITY VERIFICATION (PIV) (Submit a copy of your social

security card and driver's license, state ID or VISA to your DVAHCS POC)  Please notify POC of any changes to Driver’s License, State ID or VISA prior to orientation.   CURRENT PIV

BADGE HOLDERS (If you have a PIV badge from another VA facility, please advise your DVAHCS POC.)