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Title VI
Employment Application
Home
Employment Application
Employment Application
Step
1
of
5
20%
At SBCAG, we are committed to making it easy for job seekers to apply for positions with us. We only accept online applications and do not accept hardcopy, faxed, or emailed application forms, resumes, or letters. To ensure your application is considered complete, please fill out all the online sections. If you choose to use “see resume” as an answer to any question, this will count as an incomplete application. If you have any questions about our online application process, please contact Human Resources. Thank you for considering a career at SBCAG.
Position Applying For
(Required)
Name
(Required)
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
Prefix
First
Middle
Last
Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Maryland
Massachusetts
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Northern Mariana Islands
Ohio
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Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Home Phone:
(Required)
Business Phone:
(Required)
Social Security Number:
(In accordance with the Federal Privacy Act of 1974, disclosure of your Social Security Number is voluntary. Social Security Number will be used for identification purposes to ensure proper records are maintained.)
Where did you hear about this job?
(Required)
Online job posting
Professional Association
SBCAG Website
Social Media
Newspaper
Other
May we contact you at your business number?
(Required)
Yes
No
May we contact your current employer?
(Required)
Yes
No
Can you submit proof of your legal right to work in the United States?
(Required)
Yes
No
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?
(Required)
Yes
No
If no, describe the functions that cannot be performed.
Are you related to anyone who works for the Santa Barbara County Association of Governments by blood, marriage or adoption?
(Required)
Yes
No
If yes, Name
Relationship
Do you have a valid California driver’s license?
(Required)
Yes
No
Class
What language(s), other than English, do you speak fluently?
(Required)
Indicate the type of appointments(s) you will accept:
(Required)
Full-time
Part-time
Temporary
15. If hired, on what date can you start work?
(Required)
MM slash DD slash YYYY
Salary Desired:
(Required)
Experience
Please provide enough information to allow for review and evaluation of your work experience and abilities. List the positions you have held starting with your current or most recent job. Include relevant volunteer experience. If you were employed under another name, write in the name by which you were known to your employer. This section must be fully completed. A resume may be attached but will not be accepted in place of this section.
Recent Employment
From
(Required)
Month
Day
Year
To
(Required)
Month
Day
Year
Hours per week
(Required)
Please enter a number less than or equal to
80
.
Employer (Business or Agency Name)
(Required)
Title of Your Position
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
Number of Employees Supervised by you
(Required)
Supervisor Name
(Required)
First
Last
Supervisor Phone No.
(Required)
Duties (Be Specific)
(Required)
Employment #2
From
(Required)
Month
Day
Year
To
(Required)
Month
Day
Year
Hours per week
(Required)
Please enter a number less than or equal to
80
.
Employer (Business or Agency Name)
(Required)
Title of Your Position
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
No. of Employees Supervised by you
(Required)
Supervisor Name
(Required)
First
Last
Supervisor Phone No.
(Required)
Duties (Be Specific)
(Required)
Education
Did you graduate from High School?
(Required)
Yes
No
Did you receive a GED?
(Required)
Yes
No
If "No", indicate highest year completed:
(Required)
Higher Education
Undergraduate, Business or Trade School Name and Address
Major
Type of Degree
Undergraduate, Business or Trade School Name and Address
Major
Type of Degree
Undergraduate, Business or Trade School Name and Address
Major
Type of Degree
Graduate Work
Undergraduate, Business or Trade School Name and Address
Major
Type of Degree
Undergraduate, Business or Trade School Name and Address
Major
Type of Degree
Equivalent Training, Education, and Experience
If you do not meet the experience requirement, you may still qualify for this position. The Employment Standards on the Job Bulletin may indicate that an equivalent combination of training, education and experience that provides the required Knowledge and Abilities is also acceptable. If the Job Bulletin contains this provision and if you possess the required knowledge and abilities, please describe how you obtained the knowledge and abilities by completing this section in addition to completing the Employment Experience section above.
Description of equivalent training, education, and experience:
References
Provide names and addresses of three people, not relatives, that we may contact who have knowledge of your job skills, experience, and ability. You may use past employers
Name
(Required)
Address
(Required)
Phone
(Required)
Business or Occupation
(Required)
Name
(Required)
Address
(Required)
Phone
(Required)
Business or Occupation
(Required)
Name
(Required)
Address
(Required)
Phone
(Required)
Business or Occupation
(Required)
Applicant Certification
Consent
(Required)
I agree
I understand that SBCAG reserves the right to inquire about my criminal history once it has been determined that I meet the minimum employment requirements for the position.
Consent
(Required)
I agree
I understand that SBCAG reserves the right to inquire about my criminal history once it has been determined that I meet the minimum employment requirements for the position.
Consent
(Required)
I agree
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
Consent
(Required)
I agree
I hereby authorize the Santa Barbara County Association of Governments to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
Consent
(Required)
I agree
Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I initial the box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have initialed the box below.
Consent
(Required)
I agree
I waive receipt of a copy of any public record described in the paragraph above.
Resume Upload
(Required)
Max. file size: 100 MB.
Cover Letter Upload
(Required)
Max. file size: 100 MB.
Supplemental Documents
Max. file size: 100 MB.
Signature
By signing my name below I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application.
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