Beruflich Dokumente
Kultur Dokumente
I~ORNIA- STATE PERSONNEL BOARD Applications will be processed ONL Y for classifications where an examination
EXAMINATION AND/OR is in progress and the published final filing date has not passed, or for vacant
positions where a department requests an application.
EMPL9Y~ENT APPLICATION
STD. 678 (REV. 12/2006) Page 1 PRINT OR .TYPE - PLEASE SEE INSTRUCTIONS ON BACK PAGE
~;9-i:.oh>t
(Street)
dGounty)
IE-MAIL ADDRESS
FOR SPOT EXAMINATIONS, ENTER THE LOCATION WHERE YOU WISH TO WORK
ANSWER THE FOLLOWING QUESTIONS: (Answer questions 8, g, 10, andlor 11 only if the examination indicates they are required.)
1. Enter the county in which you would like to take the .....
examination if different from the county of your residence: I fYlA.cl..PiLA- I rl"tA~,.., il Cf I ViS I "AAJ5t'.c..
r r I
2. Do you need reasonable accommodation to take an interview or written test? . o YES ~
3. Do your religious beliefs prevent you from taking an examination on Saturday? ••••••••••••••••••••••••••••••• ·········PP 0 YES ~
4. Are you now employed by the State of California? (If "YES", fill in the information below.)... ..... . 0 YES ~
Department: Subdivision:: _
5. Have you ever been fired, dismissed, terminated, or had an employment contract tenminated from any position for
performance or for disciplinary reasons? (Applicants who have been rejected during a probationary period, or whose
o YES ~
dismissals or terminations have been overtu rned, withdrawn [unilaterally or as part of a settlement agreement] or revoked
need not answer "Yes".) Refer to the Instructions for futher information. If "Yes" to Question #5, give details in Item #12.
:::ERTIFICATION -IMPORTANT - PLEASE READ BEFORE SIGNING -If not signed, this application may be rejected.
I certify under penalty of perjury that the information I have entered on this application is true and complete to the best of my knowledge. I further understand
that any false, incomplete, or incorrect statements may result in my disqualification from the examination process or dismissal from employment with the
State of California. I authorize the employers and educational institutions identified on this application to release any information they may have concerning
my employment or education to the State of California.
\~ () It! ?
~.,
:::Iasses 01 02 \03
I ,
,/
104
..,...
APPLICANTS-DO NOT U/;) THE SPACE BELOW-FOR PERSONNEL USE ONL Y
05 06
DATE ~)j
,
FOR PERSONNEL USE ONLY
Flags------
"VC for Series "- STATUS
WC o ACCEPTED 0 REJECTED WC
~C/Flag for Series
J EXPERIENCE LICENSE REQUIREMENT
CODES
I I I I I I I I I I EDUCATION OTHER
EXAMINATION AND/OR
EMPLOYMENT APPLICATION
STD. 678 (REV. 12/2006) Page 2
14. LIST BELOW VALID LICENSES, CERTIFICATES OF PROFESSIONAL OR VOCATIONAL COMPETENCE, OR MEMBERSHIP IN PROFESSIONAL ASSOCIATIONS
CALLED FOR IN THIS EXAMINATION ANNOU NCEMENT. (If you are an altorney, please include first Bar date with license Information if the examination announcement requires it)
DATE ADMITTED EXPIRATION IN THE SPACE BELOW, INDICATE SPECIFIC COURSE REQUIREMENTS NEEDED
lICENSE/CERTIFICATION NUMBER
TO THE BAR DATE TO SATISFY REQUIREMENTS FOR THIS EXAMINATION
Z 6~4 2oc't
HOURS PER WEEK I TOTAL WORKED (Years/Months)
. _56'1. SUPERVISOR
()1~../-I:LL FItAh't;~ tC.'C.. __ 4~ LA. 3a.-V t2.'Ut-J.2 p/~OJ"" flUbie..-.. S'o'~tl.. j..Vv.U{... w, '-+. 4LUl.
JV~>
COMPANY/STATE AGENCY NAME .J
,tJ/1
ADDRESS
Ie.Y~II\lle. ,,,,i-tItNA-J.-'''''AL 2, 1- OS,Sl /f?i!..t.. 8 fll J,..Fri'L
$ 4t-/142.~ PER veA-lt. 1. to to€. f'Jc.lJ.i'l.4/lJ hA"'" r!f.R.5N 0 t.a... 1 37 z.7
DUTIES P7RFORMED
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,a.A.eX p/~.,.) RM..o.J J~PS ;,..I ' " ,4. 1"1l...~ FIL,q"..", i-I "o{.L. Wok.. 411 -I /l.A" <! ~
EXAMINATION AND/OR
EMPLOYMENT APPLICATION
STD. 678 (REV. 1212006) Page 3
APPLICANTS NA
ME (Last)
I3I2.A 0 /..-Q.A.A. (First)
.) () h,..J
(M.!.) I
I
SOCIAL SECURITY NUMBER
57D-/l-/23&>
15. EMPLOYMENT HISTORY (Cont/;6ed)
$ £14, Lf/7
DUTIES PffiFORMED
PER
7
Ve'A e. ,
J.. iJi.. su.i k.::it II) tf
i./ 0 3 ~ S /3Iu C!<..A/'f1.1l frMIJetA ell Q3fb3Y
.stvJ4.p O ....+-. d.eJ-.o,·L ,R4A c.f. .p 141J 5
Ftl-1J1f-L w",,,d) 1-(/ IJr:L h () ""-L $ R-4/lJ (i L.l oN'
/tjq7
HOURS PER WEEK
/998
TOTAL WORKED (Years/Months)
tJo"cl -C'1l.AJ1'IIN(
COMPANYISTATE AGENCY NAME J
/-lJ/U1Mf.."; I
-----,
C:Oh1h1 ~C(/4L /Jldf S
I SUPERVIS~R
$ '3 Sj S-48 P~~Lcfnv-+ ,vc.. 'bt:t7 1: C().lh~ J'Il.-.J (!ifU.1..o.- F/lAJI\JC ('4 q 37Z,i)
DUTIES PERFORMED
PER
,v<?41L set1,,*,
I
F,t...,!:1~ C ~Ih et..CiLlL t3~/J"')$ ,2AV (·tot ..v 7J lV~p hiJ- ,24A-d' rll4lJ,}
Wood
rd../f .-L.t.. )J 141/ e loJ Spzc t.i ..." 5
$ 2 S'l 7'16
DUTIES PERFORMED
PER
r
veA/L :; 4AJ£,c.L
v
e. A-l ,
vJ~C'(j) rIC- .a...-.. 'l. Ii ..>Vh~(.,.qL. !:J ... t&,(...V ,<fQV Cu.v s /l'.dI'C ~1- ~,~£ ty14 AJ,.)
11 I'Ve. INSfr;(L.,~s
EXAMINATION AND/OR
EMPLOYMENT APPLICATION
STD_ 678 (REV. 1212006) Page 4
lIt> 'I \Ie A-tL$ Tim TIIJ "., blL C CIrI~ L. I TfYh T~b~
SALARY EARNED ADDRESS
r::/l.A~ CtA.>~ I-I~ ("tA;clAi- SI1AP plAk /2nuf plANS Cuff sl-9{/c...
Jk.e .J~b
--4s,:iA
SUPERVISOR
DUTIES
r/UI-rhL -fllAcll- I';{;\.~>e.> ? I~ 1... IArJ IV OJ"! It: s ivu i-- ;'5 I i&-&.(J ..;!ASc.~ btJt:<Ld
-REASONFORLEAVING--
~()w02 tJe.+1e1.. J D b /h lJl't.L. m trn.tu.,
FROM (M/DIY) TO (MIDIY) TITLE/JOB CLASSIFICATION (Include Ringe orLevel,lfapplicable)
f';{41'1Ul. e t.W 41V1 f7~ t.-~-CtA- t!Kl-j 5//;clc. te~()/~ 'u.j~ e.lelll'1~
/41 ?/;'W()l;,& or, Roof ~ ,V4jl Plywood.
EXAMINATION AND/OR
EMPLOYMEhlT APPLICATION
STD. 678 (REV. 12/2006) Page 5
510~ Ii -12·3~
o
AGE
(1) UNDER 21
,,~
M (3) 21 - 39 0 (6) 40 - 69 D (7) 70 AND OVER
~~
LM" MALE D FEMALE
Ethnic Category (Please check the box that best describes your racelethnicity.):
o (7) AMERICAN INDIAN OR ALASKAN NATIVE-Persons having origins in any of the tribal peoples of North America, and who maintain cultural
identification through tribal affiliation or community recognition.
-ENTEF(TRisALiDENTiFICATIClN -OR-AFF"iUATION---------------------------------------- ------------------------------------ ---------- --------------- ---------------- ---------- -----
0(2) ASIAN-Persons having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent. This includes China, Japan,
and Korea.
:::J- (1)
BLACK-Persons having origins in any of the black racial groups of Africa.
:::J- (8)
FILIPINO-Persons having origins in any of the original peoples of the Philippine Islands.
-
:::J (4)
HISPANIC-Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
-
:::J (6)
PACIFIC ISLANDERS-Persons having origins in the Pacific Islands, such as Samoa.
~ WHITE-Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.
::heck if:
----, (3)
--.J OTHER (Specify)
~ (Y) DISABLED-A person with a disability is an individual who: (1) has a physical or mental impairment or medical condition that limits one or more life
activities, such as walking, speaking, breathing, performing manual tasks, seeing, hearing, learning, caring for oneself or working; (2) has a record or
history of such impairment or medical condition; or (3) is regarded as having such an impairment or medical condition.
~ MlliTARY-A military veteran; a widow or widower of a veteran; or a spouse of a 100% disabled veteran.
John Bradley
3734 E. Dakota 93726
Fresno, CA
Objective: A position with a construction company where I can use my skills and abilities.
Forman/Supervisor
Experience:
• Built multiple bUildings(ground up) concrete to finish.
• Lifted, carried and held building materials, tools and supplies.
• Trained 10-20 men as framers
• Cleaned tools, equipment, materials and work areas.
• Can drive all kinds of equipment: gradall scissor lifts etc.
• Supervised 10-20 men, scheduled work hours, resolved conflicts, determined
salaries.
• Bolted, nailed, aligned and blocked up under forms.
• Erected scaffolding, shoring and braces.
• Applied caulking compounds by hand and with caulking gun to seal crevices.