Name of Facility: security number on this form will not prohibit employment consideration. For purposes of compliance with The Immigration Reform and Control Act, are you legally eligible for employment in the United States?Access a complimentary employment application template here, and gain insight into the essential questions to incorporate. 1. Position applied for: The specific job title you are applying for. Virginia Job Application Fill super Out Printable. Virginia Job Application Fill Out Printable PDF Forms Online. CERTIFICATION--Each Application Requires Current Date and Original Signature. PDF editing your way. Complete or edit your VA DHRM Form 10-012 2003 anytime and from any device using our web, desktop, and mobile apps. It includes personal information, work history, education, skills, and qualifications, as well as specific prompts to evaluate their suitability for the job.