2. CITY OF LAGUNA NIGUEL
   30111 Crown Valley Parkway Laguna Niguel, CA 92677 (949) 362-4300
3. EMPLOYMENT APPLICATION FOR THE POSITION OF:*
5. 
6. APPLICANT INSTRUCTIONS
   Please read the recruitment announcement for the position desired. if you possess the qualifications for the job, show clearly on this application all previous education, training and work experience which qualify you for this position. Answer all questions accurately and completely. All statements in your application are subject to verification and incorrect or incomplete statements may bar you for employment. Read the Certificate of Applicant in Section 7 carefully before signing.
8. 1. PERSONAL INFORMATION
10. First Name*
11. Last Name*
13. Telephone*
14. Email Address*
16. Address
18. City
19. State
20. Zip
22. Do you have a valid Driver's License?*

    1. YES
    2. NO
23. Are you presently authorized to work in the U.S.?*

    1. YES
    2. NO
24. Are you at least 18 years of age?*

    1. YES
    2. NO
25. If no, can you submit a valid work permit?

    1. YES
    2. NO
29. 2. EDUCATION AND TRAINING
    Attach additional sheets if necessary
31. Select Highest Grade Completed*
    -- Select One --123456789101112
32. Name and Location of Last grade or High School Completed
33. Did you Graduate?*

    1. YES
    2. NO
34. Do you have a GED Certificate?*

    1. YES
    2. NO
36. Name of College, Universities, Business or Trade Schools Attended
    Include Location, Number of Units Completed, Semester/Quarter system, Major Subjects and Title of Degree
38. Please describe additional course work or training (including military) which would qualify you for this position
40. Please list certificates or licenses of professional or vocational competence you possess which relate to this position
42. Please describe any pertinent skills you have such as typing, shorthand, computer, machine or equipment operation, or foreign language skills
46. 3. EXPERIENCE
    List all jobs you have held in the last ten years beginning with your most recent job including pertinent military service and volunteer work. List each promotion as a separate job. If you need more space, you may attach additional sheets. Complete this section even if you are attaching a resume.
48. MAY WE CONTACT YOUR PRESENT EMPLOYER?*

    1. NOT APPLICABLE
    2. PLEASE DO
    3. PLEASE DON'T
50. EMPLOYER # 1
    Include Name, Address & Telephone Number of Employer
51. Title of Position & Duties Performed
52. No. of Hrs. Per Week*
54. Name of Supervisor
55. Reason for Leaving*
56. FROM*
    FROM Start Date

    —

    FROM End Date
58. EMPLOYER # 2
    Include Name, Address & Telephone Number of Employer
59. Title of Position & Duties Performed
60. No. of Hrs. Per Week*
62. Name of Supervisor
63. Reason for Leaving*
64. FROM*
    FROM Start Date

    —

    FROM End Date
66. EMPLOYER # 3
    Include Name, Address & Telephone Number of Employer
67. Title of Position & Duties Performed
68. No. of Hrs. Per Week*
70. Name of Supervisor
71. Reason for Leaving*
72. FROM*
    FROM Start Date

    —

    FROM End Date
76. 4. A "YES" ANSWER TO ANY OF THE NEXT 3 QUESTIONS WILL REQUIRE ADDITIONAL INFORMATION
78. Have you ever been employed by the City of Laguna Niguel?*

    1. YES
    2. NO
79. Dates*
    Dates Start Date

    —

    Dates End Date
80. Department(s)*
82. Are you related to anyone currently employed by the City of Laguna Niguel?*

    1. YES
    2. NO
83. Name & Department*
85. Are you related to a current City of Laguna Niguel City Council Member?*

    1. YES
    2. NO
86. If so, please name the City Council Member and provide a brief description of the family relationship.*
90. 5. ADDITIONAL INFORMATION

    Use this space to provide additional information or to describe in greater detail any aspects of your experience or activities pertinent to the job you are seeking.

94. 6. REFERENCES
    List three references (individuals not related to you who are familiar with your employment qualifications and personal background)
96. Reference # 1
98. First Name*
99. Last Name*
101. Address
103. City
104. State
105. Zip
107. Telephone Number*
108. Relationship
110. Reference # 2
112. First Name*
113. Last Name*
115. Address
117. City
118. State
119. Zip
121. Telephone Number*
122. Relationship
124. Reference # 3
126. First Name*
127. Last Name*
129. Address
131. City
132. State
133. Zip
135. Telephone Number*
136. Relationship
138. 7. UPLOAD FILES
     Please attach Resume, Cover Letter or any additional files that relate to the job you are applying for.
140. Resume
141. Cover Letter
142. Additional Documents
144. How did you hear about this position?*
146. 8. CERTIFICATE OF APPLICANT- PLEASE READ CAREFULLY
     I have read and understand all the information contained in this application. I authorize the release of information concerning my qualifications, character, or prior employment record to the City of Laguna Niguel through inquiries to any sources, except as noted in Section 3. I certify that all statements in this application are true and complete; that there are no misrepresentations, falsifications, or omissions of material fact and am aware that any misstatements or omissions of material fact may cause rejection of my application, disqualification from competing for, or discharge from any employment in this jurisdiction. Furthermore, I may be required to submit verification of any information provided on this application. I understand that as a condition of employment I may be required to take and pass medical and psychological tests including drug and alcohol screens.
148. Signature*
149. Date*
     Date
151. ADDITIONAL INFORMATION*

     You will receive an email confirmation two business days after your application is submitted from Human Resources. If you do not receive an email confirmation, please contact City Hall. Thank You.

     1. I Understand
153. CITY OF LAGUNA NIGUEL IS AN EQUAL OPPORTUNITY EMPLOYER
Leave This Blank:


157. 1. Receive an email copy of this form.
158. Email address

     This field is not part of the form submission.

159. Submit Submit and Print

* indicates a required field