IT WORK ASSESSMENT

Instructions for Completing the IT Work Assessment Form

What is the IT Work Assessment form?

The IT Work Assessment Form was developed to allow an employee in the IT classifications to objectively capture their work history, skills and abilities for work performed prior to July 1, 2019. In the event of a layoff, reversion, or other relevant employment action, the IT Work Assessment Form can be submitted along with any other relevant information to determine employee options and/or comparability with the newly established IT Professional Structure.

When do I complete the form?

Employees may complete the form at any time. The IT Work Assessment form can be found on the State Human Resources Forms Website.

Instructions

Once you have completed this form, keep a copy for your records and provide the original to your HR office for placement in your personnel file.

Section 1

Complete this section as accurately as possible.

Section 2

List all education including IT related courses.

Section 3

List all relevant licensures and certifications. Indicate active or inactive status and expiration dates.

Section 4

List all IT related training and dates of training.

Section 5

Document your job tasks, knowledge, skills and abilities in the specific job families for which you have work experience. Refer to the IT Work Assessment Guide document for additional help completing this section.

Other Resources

ITPS Resources website

Evaluator’s Handbook

Glossary - Classification

1. Personal Information
Last Name	First Name	Middle Initial
Enter Last Name Here	Enter First Name Here	Enter Middle Initial Here
Personnel ID	Work Phone	Agency
Enter Personnel ID Here	Enter Work Phone Here	Enter Agency Here
Work Email	Current Job Position/Title
Enter Work Email Here	Enter Current Job Position/Title Here

2. Education
High School Diploma or GED: ☐	Some College: ☐	# of Years:	Degree: ☐
Degree Type:	Enter Degree Type Here	Related Coursework:	Enter Related Coursework Here
3. Licensures / Certifications
Enter Licensures/Certifications Here	Date(s) Enter Date(s) Here

4. IT Training
Enter IT Training Here	Date(s) Enter Date(s) Here

5. Job Families
Application Development
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Ranges Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Architecture
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Business Analysis
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

Customer Support
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

Data Management
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Policy and Planning
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here
Network and Communications
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Project Management
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Security
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

Systems Administration
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

IT Vendor Management
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here
Quality Assurance (QA)
Position Title(s):	Enter Position Title(s) Here	Date Range(s):	Enter Date Range(s) Here
Job Tasks, Knowledge, Skills & Abilities:	Enter Job Tasks, Knowledge, Skills & Abilities Here

Employee Signature:	Enter Employee Signature Here	Date Submitted:	Enter Today’s Date Here