1400 Highland Avenue, Manhattan Beach, CA, 90266, US
INSTRUCTIONS - PLEASE READ CAREFULLY:
Applicant's Full Name
Applicant's Mailing Address
Emergency Contact Name
Emergency Contact Address
High School Graduate Status
Have you attended any colleges, universities, business or trade schools that are applicable to this position?
Add more School?
Begin with your most recent experience. List all experience within the last 10 years, including U.S. military service and periods of unemployment. Give details on the experience which you believe meets the entrance requirements for this position. Go back more than 10 years if necessary. Also, list any volunteer experience which you feel helps you meet the requirements for the job. Must provide details of any gap of employment that is over one year (i.e. in school, unemployed, etc.). Resume may be submitted in addition to your application, but the information below must be completed. Upload additional page of Work Experience if necessary, including the same information categories requested below.
May we contact your present employer?
Add Work Experience?
Add more Work Experience
Add another Work Experience
Do you have a valid Driver's License?
Are you at least eighteen (18) years of age?
Can you submit a Birth Certificate or other proof of U.S. citizenship or proof of resident alien status if selected for hire?
Do you have any relatives currently employed by the City of Manhattan Beach?
Have you ever worked for the City of Manhattan Beach?
Are you currently or have you ever been enrolled in CalPERS?
Were you ever discharged, rejected during probation or have you resigned under pressure or unfavorable circumstances from any employment?
Do you claim Veteran's credit for wartime service? (12/07/41 to 12/31/46; 6/27/50 to 1/31/55; 8/5/64 to 5/7/75; or 8/2/90 to 4/10/91)
From what source did you learn of this position? (Check all that applies)
The purpose of this questionnaire is to provide applicants the opportunity to describe in detail their experience as it relates to the duties of this position. Respond as briefly as possible, but be specific, thorough, and accurate in providing details. This supplemental questionnaire will be used to assist the City of Manhattan Beach in selecting candidates to participate further in the selection process. Attach additional pages if necessary. Be sure to limit your response to no more than one (1) page for each question.
I hereby request, authorize and consent to the release of information to the City of Manhattan Beach regarding my previous and/or current employment with the Responding Agency for the purpose of evaluating my suitability for employment. I further authorize the Responding Agency or its agent to respond to any verbal or written request regarding my employment record, including but not limited to: positions held; dates of employment; beginning and end pay rates; work performance; disciplinary records, including any records which were sealed as part of a settlement; reliability and any incidents of dishonesty; insubordination, violence and/or unsafe behavior; harmful or threatening behavior, including information based upon materials in my personnel file. I direct the Responding Agency or its agents to release such information regardless of any agreement, instructions or representations I may have previously made with Responding Agency to the contrary. I further authorize the Responding Agency or its agents to answer whether it would rehire me.
In addition, I authorize the Responding Agency to release the contents of and/or to provide a photocopy of my entire personnel file with Responding Agency, if requested by the City of Manhattan Beach, including any documents sealed pursuant to any settlement agreement or stipulation, and all application information including questionnaires, interviews, and education transcripts. I further authorize the disclosure of all records to which, as an employee, I would have or did have access under Labor Code section 1198.5 or for firefighters Government Code sections 3255 and 3256.
I have received a copy of this Waiver and Release and had adequate time to review it. I understand the meaning and purpose of this Waiver and Release, and by signing this document, I release the Responding Agency including its officers, employees, or related personnel both individually and collectively, from any and all liability for damage of whatever kind, which may at any time result to me, my heirs, and family associates because of this Waiver and Release or any attempt to comply with it. Specifically, the Responding Agency will not be subject to any civil liability for any relevant cause of action by virtue of releasing information identified above in compliance with California Civil Code Section 47 as amended.
This Waiver and Release will expire one (1) year after the date signed. A photocopy of this Waiver and Release is to be considered as valid as an original.
I hereby certify that all statements made in this application are true and complete to the best of my knowledge and belief. I authorize the City of Manhattan Beach to investigate my qualifications, employment record or character through inquiries to any sources mentioned in this application, unless otherwise stated in this application, and I understand and agree that any misstatements or omissions of material fact herein may cause forfeiture on my part of all rights to employment by the City of Manhattan Beach.
I further agree to be fingerprinted, to submit to a complete medical examination by a City physician, to sign an oath of office, and to furnish such proof of education and citizenship or legal right to work in this country as may be required as a condition of employment. Completion of these conditions does not imply an offer of employment.
In accordance with California Government Code section 3100, et., seq. all City of Manhattan Beach employees are considered disaster service workers who may be required to report to duty, or remain on duty to address disaster service activities in the event of an emergency or disaster and are required to undertake an application loyalty oath.
Upload Resume and/or Cover Letter
Upload Diploma, College Transcript, professional certificates or licenses
Upload Supplemental or Additional Pages
The City of Manhattan Beach consideres qualified applicants for employment without regard to race, color, religion, national origin or ancestry, disability, genetic information, gender, age, sexual orientation, covered veterans status, or any other protected status. The information obtained may only be used to provide statistical information on applicant flow patterns to the Federal Equal Employment Opportunity Commission (41 CDF 60-2.12). While your reply will be most helpful to use in reporting accurate data, disclosures in this section are completly voluntary.
Completing this section is for inclusion in statistical reports required by various governmental regulations and agencies. This information is not part of the selection process.
Race/Ethnic Identification (check one):