SUPERIOR COURT OF CALIFORNIA



FOR OFFICE USE ONLYReviewer?__________Date?______ Qualified Hold – must submit: _________________________By:?_________________________ Rejected for: Experience Education Late Filing Verification Other:SUPERIOR COURT OF CALIFORNIACOUNTY OF SAN FRANCISCOEMPLOYMENT APPLICATIONSubmit Completed Materials to the Address Indicated on the Job AnnouncementDate Received COMPLETE APPLICATION PACKAGE DUE BY 4:00 PM, NOVEMBER 30, 2016ANSWER ALL QUESTIONS - TYPE OR PRINT IN INKREAD THE RECRUITMENT ANNOUNCEMENT BEFORE COMPLETING THIS FORMPosition I am applying for: FISCAL TECHNICIAN (ACCOUNTING CLERK) (Class Code 472C)Last NameFirst NameMiddle InitialStreet Address and Apt. No.E-Mail AddressPrimary Telephone Number( ) -CityStateZip CodeSecondary Telephone Number( ) -Other surname(s) I have used: _________________________________________________________________________________You may ? may not ? contact my present employer: _______________________________________________I can speak ? read ? write ? the following language(s) besides English: ____________________________________Have you, as an adult, ever been convicted, fined, placed on probation or given a suspended sentence, for a crime or traffic offense, in any court of law or military court? (Do not include juvenile offenses if the record has subsequently been sealed by court order.)Yes ? No ?(Please note: A conviction is not an automatic bar to employment. Each case is considered on its individual merits.)Date of ConvictionLocation of ConvictionDescribe Nature of OffenseEDUCATION:Check appropriate box if you possess one of the following:High School Diploma ? G.E.D. Certificate ? California High School Proficiency Certificate ? State the highest grade or educational level achieved:college, business schools &special trainingname & locationdatesattendedcourse of study/majordegree awardedunits completedtype of degree certificatedate degree requirements completedyesnosem.qrtr.a)b)C)WORK HISTORY (Resumes will not be accepted as a substitute for completing this section).1.List work history (including military service and applicable volunteer experience) for the last TEN (10) years.Begin with most recent experience. Explain any gaps between employment.2.List experience, regardless of date, which demonstrates that you meet the minimum requirements.3.Describe duties as completely as possible; if supervisory, list number of employees supervised.If you held more than one position with the same employer, list each separately.mo/yrmo/yrTOemployer (business or agency name)title of most recent positionname of supervisorhrs per weekstreet city/statezip salarydutiesreason for leavingmo/yrmo/yrTOemployer (business or agency name)title of most recent positionname of supervisorhrs per weekstreet city/statezip salarydutiesreason for leavingmo/yrmo/yrTOemployer (business or agency name)title of most recent positionname of supervisorhrs per weekstreet city/statezip salarydutiesreason for leavingmo/yrmo/yrTOemployer (business or agency name)title of most recent positionname of supervisorhrs per weekstreet city/statezip salarydutiesreason for leavingTIME NOT ACCOUNTED FOR ABOVE:FROMTOEXPLANATIONMONTH/YEARMONTH/YEARCERTIFICATION OF APPLICANT: (READ CAREFULLY) I hereby certify that all statements made in this application are true and complete to the best of my knowledge. I understand that any false, incomplete, or incorrect statement, regardless of when it is discovered, may result in my disqualification or dismissal from employment with the Superior Court of California, County of San Francisco. I hereby authorize all my employers and schools (unless otherwise noted on Page One) to release any and all information concerning me, including information of a confidential or privileged nature. I HEREBY RELEASE ANY AND ALL EMPLOYERS AND THE SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO, FROM ANY LIABILITY OR DAMAGE WHICH MAY RESULT FROM FURNISHING THE INFORMATION REQUESTED.DATE:SIGNATURE OF APPLICANT:In addition to the chronological work experience and education information required on the attached pages, you must also respond to each of the four items listed below on separate pages. Limit your response to no more than one 8 ? X 11 page per item. Restate the item at the top of each page and initial each page individually.When responding to items 1-3:?Specify your role in the specific work situations you cite.?State your employer at the time the example occurred.?Provide the approximate dates of the work experience and your job title at the time.?Indicate the percentage of the outcome of the project or program for which you claim responsibility.Describe your accounting and statistical record keeping work experience that has specifically included the following: processing accounting matters, bookkeeping and/or financial record keeping, verifying correctness of financial documents, maintaining expenditure records and reconciling subsidiary accounts.From your work experience, describe your most complex fiscal or accounting analysis using Excel. Describe any challenges you faced while performing this work. Describe a specific example of your work experience that best demonstrates your ability to use good public relations techniques, and to deal tactfully and courteously with the public and other staff when explaining the functions and policies of the work area where you are/were assigned.Provide a list of college courses you completed in accounting, specifying the name and location of the college or university, the number of credits and whether the credits were semester or quarter credits, and the date(s) completed.VOLUNTARY QUESTIONNAIREThis page is kept in the Human Resources Office for statistical record keeping purposes onlyand is removed prior to application review by any selection panel.FISCAL TECHNICIAN (ACCOUNTING CLERK) (Class Code 472C)Final Filing Date: 4:00 PM, November 30, 2016Name:(Last)(First)(M.I)This information is voluntary and will not be used for employment decisions. Please check one box next to the category that applies to you.?Hispanic/Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin. ?White (Non Hispanic/Latino): All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East. ?Black/African American (Non Hispanic/Latino): A person having origins in any of the black racial groups of Africa.?Asian (Non Hispanic/Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. ?Native Hawaiian or Other Pacific Islander (Non Hispanic/Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. ?American Indian or Alaska Native (Non Hispanic/Latino): A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment. ?Two or More Races (Non Hispanic/Latino): A person who identifies with two or more racial categories named above.GENDER: (Check one.)?Male?FemaleREASONABLE ACCOMODATION:After filing an application, the remaining examination process may require participating in a written skills test and in an oral interview. Qualified candidates with disabilities may require reasonable accommodation to participate in the selection process. Do you need accommodation to participate in this examination??No?YesIf yes, Court Human Resources personnel will contact you at the primary telephone number listed on the application to discuss accommodation need.SFSC App (Rev 8/16) ................
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