CITY OF HUNTINGTON PARK EMPLOYMENT APPLICATION
HUMAN RESOURCES DEPARTMENT FOR THE POSITION OF:
6550 Miles Avenue
Huntington Park, CA 90255
Phone (323) 584-6227 • 24-Hour Job Hotline (323) 584-6209
www.hpca.gov
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 qualifies you for this position. Please print clearly in ink or type. Answer all questions accurately and
completely. All statements in your application are subject to verification and incorrect or incomplete statements may bar or remove you from employment. Read the
Certificate of Applicant in Section 6 carefully before signing.
1. PERSONAL DATA
Name (Last) ( First) (Middle)
Area Code Home Telephone Number
Area Code Work Telephone Number
Home Address (Number and Street)
Area Code Cell Phone Number
Do you have a valid California Driver’s License? YES NO
State: Number: Class: Expiration Date:
Can you, after employment, submit proof of U.S. Citizenship or proof of permanent resident alien status? YES NO
Are you at least 18 years of age? YES NO
If no, can you submit a valid work permit? YES NO
Do you claim Veteran’s Preference? YES NO
If yes, proof of honorable discharge (DD214) from U.S. Armed Forces must be attached at time of application.
Will you accept part time work? YES NO
Will you accept temporary work? YES NO
Date of Birth: (Police Applicants only)
What languages, other than English, do you speak
fluently?
Personal References (List persons not related to you).
2. EDUCATION AND TRAINING (Attach additional sheets if necessary)
Name and location of last grade or high school attended:
Do you have a GED Certificate?
Name and location of Colleges, Universities, Business
or Trade Schools attended:
Please describe additional course work or training (including military) which would qualify you for this position.
Please list certificates or licenses of professional or vocational competence you possess which relate to this position.
Please describe any relevant skills you have such as computer skills (hardware and software), machine or equipment operation.
Have you ever been employed by the City of Huntington Park? YES NO
From _________________________ To ________________________ Department ______________________
The City has a Nepotism Policy which may preclude employment of certain family members of current employees of the City. Are you related to any present City
employee or elected official of the City of Huntington Park? YES NO If yes, please provide:
Relative’s name(s) ____________________________________ Relationship: ______________________________________
3. A “YES” ANSWER TO ANY OF THE NEXT 2 QUESTIONS REQUIRES AN EXPLANATION UNDER SECTION 4.
Please complete the section below only if you are applying for a Police Department position.
Have you at any time in your life been convicted or adjudicated, in other than a juvenile court, of a felony or misdemeanor other than minor traffic violations? YES NO
A criminal record does not constitute automatic bar to employment, but will be considered in terms of the work to be performed. Failure to disclose a criminal conviction
will result in termination. If yes, indicate below for each offense the (1) Date, (2) Offense, (3) Place, and (4) Action Taken.
Have you ever been discharged or requested or forced to resign from any position for misconduct or unsatisfactory service? YES NO
4. ADDITIONAL INFORMATION
Use this space to provide additional information as required by this application, or to describe in greater detail any aspects of your experience or activity that are pertinent to the
job you are seeking.
AN EQUAL OPPORTUNITY EMPLOYER
