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Jobid 649 31987

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employment application
Thank you for your interest in working at SANDAG.
We appreciate the opportunity to review your employment qualifications. To ensure we have all
your pertinent information and in order to best evaluate your suitability for a position, we ask you
to complete our Employment Application.
Candidates submitting incomplete applications may not be considered for employment. You
are welcome to submit a cover letter, resume, and/or writing samples but these items are not a
substitute for completing this application form. A detailed Job Announcement is created for each
job opening. Check the Job Announcement for any additional application requirements, such as the
submittal of a work or writing sample, or responses to job-specific supplemental questions.
In compliance with the Americans with Disabilities Act (ADA), SANDAG will accommodate
persons who require assistance in order to apply for a position at SANDAG. Applicants requiring
an accommodation due to a disability during any stage of the recruitment and selection process,
including requesting this document and related application materials in an alternative format,
should make their needs known by contacting Human Resources at (619) 699-1900,
fax (619) 699-6905, TTY (619) 699-1904, or hr@sandag.org.
Any information you provide will be kept confidential to the extent permitted by law.
401 B Street, Suite 800 | San Diego, CA 92101- 4231 | (619) 699 -1900 | Fax: (619) 699-6905 | TTY (619) 699-1904 | www.sandag.org | hr@sandag.org
Name:
Position:
Personal Information
Name: Phone (Cell):
Phone (Other):
Email:
Address:
City: State: Zip:
Education/Training
List the schools you attended (high school and above), starting with the most recent. List the number of years or units
completed, the degree, certificate, or diploma earned, and your major or type of program.
Professional License, Registration, Certification
List any licenses, registrations, or certifications you possess that are pertinent to this position. (Examples: AICP, PE, CPA, etc.)
Additional school courses, training, or other qualifications pertinent to this position:
Educational Institution
Did you graduate?
If no, specify units
completed
Degree, Certificate, or
Diploma Earned
Major/Minor
or Program Type
License, Registration, or Certification Number Date Received Expiration Date Licensing Agency
Language Skills
Other than English, do you possess language skills that you could use in your work?
(This information is voluntary unless stated as required in the Job Announcement.)
Yes No
If yes, in what language(s) do you speak fluently?
Software Skills
The section below allows you to tell us about your skills using various software programs. Please complete the
information by filling in the circle that indicates your present skill level. Comments or examples of your skills also may be
provided.
Other Skills and Abilities
List other skills/abilities you possess that are pertinent to this position.
0 1 2 3 4 5
Comments/Examples
None
Basic
Intermediate
Advanced
MS Word
MS Excel
MS PowerPoint
MS Outlook
Other Programs
Work Experience
Beginning with your current or most recent position, please provide us with details of your employment experiences
(paid or unpaid) for at least the past ten years. Any significant change in job title/duties under the same employer can be
considered a separate position. Attach additional sheets if necessary. While a resume may be submitted with this
Employment Application as additional information, it does not substitute for fully completing this section.
Employer
Name:
Employer
Name:
Type of
Business:
Type of
Business:
City, State
Zip:
City, State
Zip:
Average
Hours Per
Week:
Average
Hours Per
Week:
Job Title:
Job Title:
Start Date:
Start Date:
Primary Duties and Responsibilities:
Primary Duties and Responsibilities:
Reason For Leaving:
Reason For Leaving:
End Date:
End Date:
Full Time
Full Time
Part Time
Part Time
Work Experience (Continued)
Employer
Name:
Employer
Name:
Type of
Business:
Type of
Business:
City, State
Zip:
City, State
Zip:
Average
Hours Per
Week:
Average
Hours Per
Week:
Job Title:
Job Title:
Start Date:
Start Date:
Primary Duties and Responsibilities:
Primary Duties and Responsibilities:
Reason For Leaving:
Reason For Leaving:
End Date:
End Date:
Full Time
Full Time
Part Time
Part Time
Work Experience (Continued)
Employer
Name:
Employer
Name:
Type of
Business:
Type of
Business:
City, State
Zip:
City, State
Zip:
Average
Hours Per
Week:
Average
Hours Per
Week:
Job Title:
Job Title:
Start Date:
Start Date:
Primary Duties and Responsibilities:
Primary Duties and Responsibilities:
Reason For Leaving:
Reason For Leaving:
End Date:
End Date:
Full Time
Full Time
Part Time
Part Time
Additional Information
Please explain any significant gaps in your employment history.
Applicant Certifies:
All statements in this application are true and correct to the best of my knowledge and belief. I understand that false
or misleading answers are cause for rejection of this application or dismissal from employment. I also understand that if
indicated in the Job Announcement for the position I am applying for, a background check that may include information
regarding my criminal records or financial report may be obtained and used by SANDAG in making a hiring decision.
By submitting my application to SANDAG, I authorize employers, schools, law enforcement agencies, and other individuals
and organizations named in this application to provide candid and full information regarding my work record, job
performance, character, ability, and fitness to authorized employees of SANDAG. I understand that the information may be
positive, negative, confidential, and/or privileged in nature and may be used by SANDAG in any phase of the employment
process. I release current and previous employers, schools, law enforcement agencies, individuals, organizations, and
SANDAG and its employees/representatives from any liability and/or damages that may result from the release, receipt, or
use of requested information.
By checking the I Agree box below, I hereby certify that I have read and understood the instructions, conditions, and other
information provided in this document.
Is a member of your family currently employed by SANDAG? If so, please
state the employee’s name and their relationship to you in the space below.
Are you legally authorized to work in the United States?
If yes, provide date(s):
If other, please specify:
Signature:
Please type name if submitting application electronically.
Date:
Have you worked at SANDAG before?
How did you hear about this job?
I Agree
Yes
Yes
Yes
No
No
No
Explanation (Use the space below to supply any additional information relevant to the job questions above.)
The San Diego Association of Governments is an equal opportunity employer and considers applicants for all positions
without regard to race, color, religion (all aspects of religious beliefs, observance, or practice, including religious dress and
grooming practices), national origin (including language use), ancestry, age (40 and above), gender identity or expression
(including transgender, gender fluid, or gender transition status), sex (including pregnancy, childbirth, breastfeeding, or
related medical conditions), medical condition (including cancer, or a record or history of cancer), physical disability, mental
disability, genetic information, sexual orientation, marital status, registered domestic partner status, veteran status or
current or prospective service in the uniformed services, or any other category protectedunder federal, state, or local law, in
accordance with all applicable laws and regulations.
Save Form Print Form Reset Form
SANDAG Email Job Notification
Position:
voluntary statistical information
The San Diego Association of Governments (SANDAG) is an equal opportunity employer. To demonstrate our
commitment and compliance with the law, SANDAG periodically reports statistical information about applicants and
employees to the government.
Completion of this form is voluntary; it is not required as part of your application, however we would appreciate
your participation. This form will be separated from your application prior to your application being evaluated. The
information you provide will be used only for compiling statistical information. The information provided on this form
will be kept strictly confidential and will not be used in any way to make an employment decision.
Gender Age Group
Ethnicity
Are you Hispanic or Latino? (Select only one)
Race
What is your race? (Select one or more)
Veteran Status
Are you a Veteran?
Disability
Do you have a Disability?
Female Under 40 YearsMale Over 40 Years
Yes, Hispanic or Latino. A person of Cuban,
Mexican, Puerto Rican, South or Central American, or
other Spanish culture or origin regardless of race.
Yes, I am a veteran.
A person who served in the
active military, naval, or air service, and who was
discharged or released therefrom under conditions
other than dishonorable.
White (Not Hispanic or Latino)
A person having
origins in any of the original peoples of Europe, the
Middle East, or North Africa.
Black or African American (Not Hispanic or
Latino)
A person having origins in any of the black
racial groups of Africa.
American Indian or Alaska Native
(Not Hispanic or 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.
Asian (Not Hispanic or 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
(Not Hispanic or Latino) A person having origins in
any of the peoples of Hawaii, Guam, Samoa, or other
Pacific Islands.
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the
above five races.
Yes, I have a disability.
A person is considered to
have a disability if they have a physical or mental
impairment or medical condition that substantially
limits major life activity, or if they have a history or
record of such an impairment or medical condition.
No, I am not Hispanic or Latino
No, I am not a Veteran.
No, I do not have a Disability.
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Jobid 649 31987

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Completed 6 May 2022

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