Submit the completed form to the City of Los Angeles Personnel Department as instructed. You can file the application online at per.lacity.org, or send it to the Personnel Department, Employment Services Section, Room 100, 700 E. Temple Street, Los Angeles, CA 90012. You can also contact them by phone at 213-473-9163 for more information on submission options. Ensure all required fields and sections are completed accurately before submission.

Please refer to the specific job bulletin or examination announcement for relevant dates and deadlines in 2024 and 2025. Important dates may include application deadlines, examination dates, and other key milestones. For precise details, consult the City of Los Angeles Personnel Department or their website.

The purpose of this form is to facilitate the application process for individuals seeking employment with the City of Los Angeles. It is designed to gather necessary personal, educational, and work history information to assess the qualifications of applicants. Additionally, the form requests voluntary identification information to monitor the effectiveness of the City's Equal Employment Opportunity program. By completing this form, applicants provide essential details required for various examinations and employment processes conducted by the City's Personnel Department. This form also caters to specific needs such as reasonable accommodations during the selection process, verification of legal work status in the United States, and eligibility for military service credits. It ensures fairness and compliance with legal requirements while supporting the City's commitment to equal opportunity employment. Overall, this form serves as a comprehensive tool for efficiently processing job applications and facilitating hiring decisions within the City of Los Angeles, ensuring a transparent and equitable application process for all candidates.

• 1. City Job (Examination) Title: The title of the job or examination you are applying for.
• 2. Class Code Number: The specific code number assigned to the job or examination.
• 3. Social Security Number: Your Social Security Number, used for verification and record-keeping.
• 4. Name: Your full name, including last, first, and middle names.
• 5. Present Mailing Address: Your current mailing address, including street number, apartment, city, state, and ZIP code.
• 6. Preferred Contact Method: Your preferred method of contact, such as US mail or email.
• 7. Home Phone: Your home phone number, including area code.
• 8. Work Phone: Your work phone number, including area code.
• 9. Email Address: Your email address for correspondence.
• 10. P.O. Box Number: Your P.O. Box number, if applicable.
• 11. Citizenship Status: Indicates whether you are a United States citizen.
• 12. Driver's License Information: Your driver's license number, state of issue, and expiration date.
• 13. Birthdate: Your birthdate, including month, day, and year.
• 14. Verification of Legal Right to Work: Certification that you will provide verification of your legal right to work in the United States.
• 15. Gender Identification: Your gender identity, with options for male, female, and non-binary.
• 16. Ethnic Group/Race: Your ethnic group or racial identity, with various options to choose from.
• 17. Reasonable Accommodations: Information on whether you need accommodations for the selection process.
• 18. Recruitment Research: Indication of how you learned about the job opportunity.
• 19. Employment References: Authorization for the Personnel Department to contact your past and present employers for references.
• 20. Previous City Employment: Details of any previous employment with the City of Los Angeles.
• 21. Examination History: Information on any examinations you've passed in the last two years.
• 22. Employment Terminations: Details of any instances where you have been fired or asked to resign from a job.
• 23. Previous Names: List of any names you've used in the past in other records.
• 24. U.S. Military Service: Information about your military service to receive service credit.
• 25. High School Education: Indication of whether you graduated from high school or passed the GED test.
• 26. Additional Education: Details of any additional education, including universities, colleges, and trade schools attended.
• 27. Special Courses: Information about any special courses required for the examination.
• 28. Special Licenses: Details of any special licenses required for the examination.
• 29. Language Proficiency: Indication of proficiency in languages other than English.
• 30. Supplemental Information: Any additional information relevant to the application.

If you fail to submit this form, your application for employment with the City of Los Angeles will not be considered. This may result in missing the opportunity to participate in the selection process for the job you are applying for.

• Missed Job Opportunity: Your application will not be included in the selection process.
• Incomplete Application: Your application will be deemed incomplete without this form.
• Delayed Hiring Process: Not submitting the form may delay your potential hiring and job offer.

• 1. Applying for a Job: Use this form to apply for employment with the City of Los Angeles.
• 2. Seeking Promotion: Current City employees seeking promotions or new roles should use this form.
• 3. Requesting Accommodations: Use this form to request reasonable accommodations for the selection process.
• 4. Verifying Legal Right to Work: Use this form to provide verification of your legal right to work in the United States.
• 5. Requesting Military Service Credit: Veterans should use this form to apply for military service credit in open examinations.