INFORMATION FOR JOB APPLICANTS

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COUNTY OF COLUSA Human Resources Department Hours: Monday Friday (excluding holidays) 8:30 a.m. 5:00 p.m. 250 5th Street Phone: (530) 458-0420 Colusa, CA 95932 Email: ccpersonnel@countyofcolusa.org Website: www.countyofcolusa.org Please view our website and sign up for notifications (via text or email) of future job openings with our Notify Me link. INFORMATION FOR JOB APPLICANTS Thank you for considering the County of Colusa for employment. The following is a brief overview of the application and hiring process used. Any person with a disability who needs accommodation during any phase of the recruitment process is encouraged to contact us in advance. Because of the large volume of applications received, and because all applicants will be contacted by mail or email regarding the application process, we request that you not call the Human Resources Department for information regarding your place in the process. It may take approximately three to four weeks to complete our review of applications. We are also unable to provide feedback on application packages that have been submitted or on interviews. 1. The application process is an indication of your ability to understand and follow written instructions as provided on the application, job flyer, and this information sheet. Failure to include required information will result in the disqualification of your application. Please read all three documents carefully. Applicants are responsible for ensuring that application packets are complete when submitted. 2. Applications for employment are accepted only for open recruitments as they occur. The job flyers include the specific duties and requirements of each position and the closing date for filing an application. Supplemental questionnaires, résumés, cover letters, letters of recommendation, transcripts, licenses, or certificates may be required in addition to the employment application. The job flyers always state the required documents that makeup the application packet for a recruitment. Failure to submit all required documents by the deadline may disqualify your application packet from further consideration. The Human Resources Department must receive your application packet by 5:00 p.m. on the closing date of the recruitment filing date postmarks and faxes will not be accepted. 3. To allow for accurate review and consideration, your application must provide a complete and detailed description of your work experience. When a certain number of years of experience are specified as a job qualification, the full-time equivalent is required. For example, someone who has four years of half-time experience is considered to have the equivalent to two years of full-time experience. It is to your benefit to be as thorough as possible because this information will be used to determine if you are qualified for the position. A résumé or letters of recommendation may be attached, even if they are not required. Although you may attach a résumé, it is still necessary to complete the Work Experience portion on the application form. Multiple-page résumés are acceptable. 4. After the closing date, all application packets will be screened for minimum qualifications. Applicants not meeting the minimum qualifications will be notified that they have been excluded from further consideration. Applicants that meet the minimum qualifications will be notified either that they were selected for testing and/or an interview or that they were not selected for testing and/or an interview. 5. Based on the required duties, the Selection Committee will select the top applicants for oral interviews. The selected applicants will be contacted and an interview will be scheduled. Before making a formal job offer, a reference check will be conducted on the top candidate(s). Applicants will be notified before references and/or current or former employers are contacted. Those interviewed and not selected will be notified.

ADMINISTRATIVE SUPPORT POSITIONS REQUIRING KEYBOARDING CERTIFICATES: Applicants must submit a current, valid keyboarding certificate (less than one year old). A Colusa County employee who is currently in a keyboarding position is not required to submit a certificate to receive credit for the minimum typing speed. Keyboarding speeds must be certified by an employment or other authorized agency. To be valid, certificates must indicate the items listed below. If a certificate does not include one of these items, ask the issuing party to write it in: Your name Length of test (a five-minute timed test is required) Date the test was taken Address and telephone number of the agency where the test was taken Signature of the person administering the test Gross words per minute Number of errors Keyboarding tests are administered by private employment agencies for a minimal fee; Colusa County does not administer these tests. Certificates from TYPINGTEST.COM and other Web-based agencies are unacceptable because they typically do not include all of the required information and we are unable to verify the information. Photocopies of certificates are acceptable, provided the copies are clear erasures or whiteout are not acceptable. Colusa County reserves the right to verify certificates with the issuing agency. POSITIONS REQUIRING A DEGREE AND/OR LICENSE: For positions requiring an educational degree and/or professional license, the applicant may be required to submit copies of their transcripts and/or required licenses with their application packet. Please refer to the job flyer for specific instructions. REQUIRED SUPPLEMENTAL FORMS: Conviction Records Supplemental Form Required as part of the application packet if indicated on the job flyer, and upon acceptance of the job offer for all other positions if not requested on the job flyer. California (CA) Official Driver Record H-6 printout is required as part of the application packet for positions requiring a commercial license. INF-1125 printout is required upon acceptance of job offer for positions requiring a valid CA driver s license. - Extra-help temporary employees are not County employees and consequently are not eligible to apply for vacancies open only to County employees. - Colusa County is required by federal law to hire only persons authorized to work in the United States. To comply with the Immigration Reform and Control Act of 1986, employees must provide proof of identity and authorization to work. Do not include this confidential documentation in your application package. - All application materials become the property of Colusa County and, unless specified otherwise within the job flyer, will not be returned to the applicant. Retain originals and submit copies of documents you wish to keep. - The County of Colusa is responsible for protecting sensitive recruitment data and maintains confidentiality of that data, as required by the Information Practices Act. All information collected through the recruitment process complies with the provisions of that Act. - Retirees: Colusa County invites all qualified candidates to apply for positions; however pursuant to Government Code Section 21221 (h) and 21224, hiring restrictions may apply to California Public Sector Pension Plan Retirees. Please contact Human Resources for further information. COLUSA COUNTY IS AN AFFIRMATIVE ACTION EQUAL EMPLOYMENT OPPORTUNITY AMERICANS WITH DISABILITIES ACT EMPLOYER

COUNTY OF COLUSA HUMAN RESOURCES 250 5 TH STREET COLUSA, CA 95932 530-458-0420 APPLICATION FOR EMPLOYMENT Exact Title of Position applying for Name Last First Middle Initial Mailing Address (Number, Street, Apt Number) City State Zip Code Telephone Number: Home Cellular Work Email address: (REQUIRED) SSN / / optional Rate of pay expected? /hour State age if under 18 Dates available for employment Indicate all types of employment you are willing to accept Full-time? Part-time? Is there any department in Colusa County where you are not willing to work? Where? Available hours for part-time P. O. Box Please list any other names that you have ever used EDUCATION AND TRAINING High School and Location Did you graduate or do you have a GED certificate? College or University Business, Trade, U.S. Military, and/or Correspondence Schools and Location Dates Attended From mo/yr To mo/yr Units Completed Major Degree Earned College or University, Business, Trade, U.S. Military, and/or Correspondence Schools and Location Dates Attended From mo/yr To mo/yr Units Completed Major Degree Earned Professional Licenses, Registrations or Certificates License Number State Issued Date Expires Driver s License Class (check one): A B C Endorsements: What language(s) other than English do you speak and/or write? Write Speak If the position that you have applied for requires typing or keyboarding skill, what is your typing/keyboarding speed?

WORK EXPERIENCE List most current employment first Title of Position From mo/yr To mo/yr Company Name Supervisor s Name Address Phone Number Hours Worked Per Week Are you employed by this company now? May we contact them? Reason for Leaving Position Description of Duties Title of Position From mo/yr To mo/yr Company Name Address Supervisor s Name Phone Number Hours Worked Per Week Are you employed by this company now? May we contact them? Reason for Leaving Position Description of Duties Title of Position From mo/yr To mo/yr Company Name Address Supervisor s Name Phone Number Hours Worked Per Week Are you employed by this company now? May we contact them? Reason for Leaving Position Description of Duties Title of Position From mo/yr To mo/yr Company Name Address Supervisor s Name Phone Number Hours Worked Per Week Are you employed by this company now? May we contact them? Reason for Leaving Position Description of Duties PROFESSIONAL REFERENCES List Three (REQUIRED) Name and Occupation Address Phone Number

Affirmative answers to the following questions are not necessarily a bar to employment. Each case is considered in relationship to the requirements for the position. Give details to any Yes answer in the space provided below. 1. Have you been discharged, released during a probationary period or been requested to resign under unfavorable circumstances from any employment? Yes / No 2. Are you currently or have you ever worked for Colusa County? Yes / No 3. Are you related to any person(s) presently employed by the County? Yes / No Please give details for any above Yes responses: CERTIFICATE OF APPLICANT: I understand that the information I provide on this form will be used to determine whether I meet the requirements for this examination only and may serve as the basis for arriving at my final rating. I certify that all statements made in this application are true and complete to the best of my knowledge. I understand that any false statements of material facts will subject me to disqualification or dismissal. I further agree to be fingerprinted, to submit to a medical examination by a County physician and to furnish proof of age, education, legal right to work in the United States, and to submit a Conviction Records Supplemental form, as may be directed as conditions of employment. Signature Date

Please Note: Before making a formal job offer, a reference check will be conducted on the top candidate(s). Applicant(s) will be notified before the references and/or current or former employers are contacted. AUTHORIZATION TO RELEASE PERSONAL INFORMATION I, understand that in connection with the application process, the County of Colusa may request information from my past employers and/or references, and I also understand that such investigation may include a review of any criminal records. I certify that I have provided complete and truthful information to the County of Colusa regarding all sources of information concerning my past employment, education, certification and criminal conviction record, as well as any other information requested in my employment application, and have been fully informed that any misrepresentations or material omissions concerning such information will be grounds for denying my application, withdrawing any offer of employment, or immediate discharge. In order to assist the County of Colusa in obtaining documents and information to confirm my background, I hereby consent to the release of information as described below. I request, authorize and consent to the release of information to the County of Colusa regarding my previous and current employment, and authorize all employers or agents that they may designate, to respond forthrightly to verbal or written inquiries from the County of Colusa regarding my employment record, including but not limited to: positions held; dates of employment; beginning and end pay rates; work performance; discipline 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 files. Further, I direct you to release such information upon request of any duly accredited representative of the County of Colusa, regardless of any agreement, instructions or representations I may have made with you previously to the contrary. I further request, authorize and consent to the County of Colusa investigation of whether I have a record of criminal convictions, and if so, the nature of such criminal convictions and all surrounding circumstances available through lawful means. The County of Colusa has advised me that any criminal background check will focus on convictions, and that a conviction as such will not necessarily disqualify me from employment. I also waive any and all rights and claims I may have against any past employers, their employees, representatives or agents; former educational institutions, or any person listed as a reference, from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure, or release of such information by any person or party, whether such information is favorable or unfavorable to me in compliance with California Civil Code Section 47 as amended. You are entitled to a copy of all public records that the agency reviews in association with your criminal background check. A copy of the public records that we review will be furnished by checking this box. It is with full understanding and consent that I agree that a photocopy of this authorization may be used only for the purposes stated above. _ Applicants Signature Date Print Name: This authorization expires:

Code # COLUSA COUNTY AFFIRMATIVE ACTION/EQUAL EMPLOYMENT OPPORTUNITY VOLUNTARY SELF-IDENTIFICATION FORM Equal Employment Opportunity employers are required by the Federal and State of California Governments to provide statistical information about applicants and employees to demonstrate that we meet equal opportunity requirements. Your completion of this form is voluntary, however, your cooperation in completing this form will enable our organization to meet its obligations under the regulations and help us determine whether our EEO goals and objectives are being met. This information will be kept separate from your employment application and will be treated in a confidential manner. However, this information will be used to compile statistical reports and analyses for our EEO Program and is available to government agencies responsible for the enforcement of civil rights, at their request. Position applied for: Date: Please check appropriate category: For purposes of this survey, an employee or applicant may be included in the group, which he or she identifies with: Sex: Male Female Please select one category, as no person should be counted in more than one race/ethnic group. The race/ethnic categories used for this survey are: WHITE - Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East. BLACK (Not of Hispanic Origin) - Persons having primary origins in any of the Black racial groups of Africa. HISPANIC - Persons of primary cultural or origin in Mexico, Puerto Rico, Cuba, Central or South America or other Spanish derived culture or origin regardless of race. ASIAN/PACIFIC ISLANDER - Persons having primary origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, and Samoa. AMERICAN INDIAN/ALASKAN NATIVE - Persons having primary origins in any of the original peoples of North America, and who maintain culture identification through tribal affiliation or community recognition. Do you have a physical condition, which may limit your ability to perform or advance in employment? Yes No REV. 111317 If yes, what accommodation would you need?

AGE CATEGORY: 20 or below 21 29 30 39 40 49 50 59 60 and above EDUCATION: High School Graduation/GED College Degree: Associates Bachelors Masters Other (please list): HOW DID YOU FIRST LEARN OF THIS OPENING? Please check one of the boxes below: Colusa County Website Colusa One Stop County Employee Friend Human Resources Department Newspaper: Appeal Democrat Chico Enterprise Record Sacramento Bee Williams Pioneer Review Woodland Daily Democrat Other (please specify): Internet: CalJobs Careers in Government Craigslist Indeed LinkedIn Monster.com Other (please specify): Miscellaneous: Other (please specify): REV. 111317