EMPLOYMENT APPLICATION

City of Los Angeles Received:

700 East Temple Street, Room 100 11/20/2018
01:59 PM
Los Angeles, California - 90012 For Official
http://per.lacity.org Use Only:
Rivera, Jacqueline Valeria QUAL:________
ASSOCIATE COMMUNITY OFFICER DNQ:_________
2210 □ Experience
□ Training
□ Other:_______
PERSONAL INFORMATION
POSITION TITLE: Job Number:
ASSOCIATE COMMUNITY 2210 O 2017/05/11
OFFICER 2210
NAME: (Last, First, Middle) SOCIAL SECURITY NUMBER:
Rivera, Jacqueline Valeria *****3438
Former Last Name: Date And Month Of Birth:
-
ADDRESS: (Street, City, State, Zip Code)
1330 W. 57th St.
Apt #107
Los Angeles , California , US - 90037
HOME PHONE: ALTERNATE EMAIL ADDRESS:
(909)545-4649 PHONE: [email protected]
(909)545-0615
DRIVER'S DRIVER'S DRIVER'S LEGAL RIGHT TO WORK IN
LICENSE: LICENSE: LICENSE: THE UNITED STATES?:
□ Yes State: Class: ■ Yes □ No
■ No Number:

EDUCATION

SCHOOL NAME: SCHOOL TYPE: DATES:

Augustus F. Hawkins High School From August/2015 To
High School Present
LOCATION: (City, DID YOU DEGREE RECEIVED:
State) GRADUATE? High School Diploma
Los Angeles, ■ Yes □ No
California
WEBSITE:
www.hawkinshs.org

WORK EXPERIENCE

DATES: EMPLOYER: POSITION TITLE:

From August/2017 To McDonalds Crew
Present
ADDRESS: (Street , City , State , Zip COMPANY URL:
Code)
988 W. Slauson Ave.
Los Angeles , California , US - 90044
PHONE NUMBER: SUPERVISOR: MAY WE CONTACT
(323)778-3526 Melbi Arce, Store THIS EMPLOYER?
Area Supervisor ■ Yes □ No
HOURS PER WEEK: # OF EMPLOYEES SUPERVISED:
32 58
DUTIES:
Crew in charge of food preparation, order taking, and providing good
customer service to all customers.

REASON FOR LEAVING:

CERTIFICATES AND LICENSES

Nothing Entered For This Section

SKILLS
OFFICE SKILLS:
Typing:
Data Entry:
OTHER SKILLS:
Microsoft - Expert - 48 month;
LANGUAGE(S):
Spanish
■ Speak ■ Read ■ Write
English
■ Speak ■ Read ■ Write
SUPPLEMENTAL INFORMATION

TYPE:
Volunteer Experience
DESCRIPTION:

I have been a volunteer with the LAPD Cadet Program for about 2
years.

REFERENCES
Nothing Entered For This Section

Agency - Wide Questions

1. I am a current City of Los Angeles employee
(having received a Regular or Training
appointment to a City of Los Angeles Position),
or I am currently on a reserve list for the City of
Los Angeles as a result of a City layoff.
No
2. With which gender do you most identify?
(Optional)
Female
3. Please enter your race or ethnic category
(optional):
Caucasian
4. How did you hear about this employment
opportunity?
From a City of Los Angeles employee
5. If you selected "Other" in the previous question,
please specify in the text box below where you
learned about this employment opportunity. If
you learned about this job opportunity through a
website not listed in the previous question,
please enter below the name or address of the
website. (Please enter N/A below if this question
is not applicable to you)
6. As a covered entity under the Fair Employment
and Housing Act and Title II of the Americans
with Disabilities Act, the City of Los Angeles
does not discriminate on the basis of disability
and upon request, will provide reasonable
accommodations to ensure equal access to its
programs, services, and activities. To request a
disability accommodation, please complete the
Disability Accommodation Form within 14
calendar days of the submittal of the City
application. The Disability Accommodation Form
can be obtained at the following Link or by
calling the Personnel Department at (213) 473-
9163. If you request reasonable accommodation,
you will be contacted by telephone, by mail, or
by email regarding your request. Please note: we
do not provide lodging or travel
accommodations, nor is it necessary to request
an accommodation for your notification
preference. If you are in need of late test
administration due to prescheduled vacation,
religious observance, or illness, you may contact
the number on the back of your test notification
when you are officially scheduled for a test. Do
you need a reasonable accommodation to
participate in the selection process?
No
7. If you answered "Yes" to the question above,
please describe the desired accommodation.
8. Have you ever been granted an accommodation
for a previous City examination?
No
9. If you have answered "Yes" to the question
above, please describe the previous
accommodation and the year it was granted.
10. May the City of Los Angeles Personnel
Department contact your previous employers?
Yes
11. May the City of Los Angeles Personnel
Department contact your current employers?
Yes
12. Have you previously worked for the City of Los
Angeles?
No
13. If you answered "Yes" to the question above and
you are not currently employed by the City, enter
the City Department(s) you worked for and the
dates of employment.
14. Have you passed any exam by the City of Los
Angeles in the last five years?
No
15. U.S. Military credit is allowed only in open
examinations. Military service credit of 5 points,
allowed by City Charter Section 1006, will be
added to the passing score of veterans who
have served on active duty in one of the periods
authorized by the Civil Service Commission and
have been released from active duty within the
previous 5 years, or present evidence of a
military service connected disability. Veterans
credit shall be added to the passing score of the
spouse of a person killed or unable to work due
to military service connected disability. To
receive such credit you must present proof of
your (or your spouse's) honorable discharge and
dates of active duty and/or proof of a military
service connected disability to: Personnel
Department, Employment Services Division,
Room 140, 700 E. Temple Street, Los Angeles,
CA 90012. This proof must be shown each time
you file an application. I am requesting Military
Service Credit and will submit the required
documentation.
No
16. Have you ever been fired or asked to resign in
order to avoid being fired from a job?
No
17. If you answered "No" to Question 16 above,
please type "N/A". If you answered "Yes" to
Question 16, please list all cases for being fired
or being asked to resign, except layoffs for lack
of work; include the Employer's Name and
Address, and the Date and Reason for
discharge.
Promotional applicants must list all probationary
terminations while employed by the City but are
not required to list terminations occuring prior to
original City appointment if employed by the City
for at least one year.
N/A
18. List names used in the past, including names
used in other records. If not applicable, please
type N/A.
N/A
19. Date of Birth (optional)
10/08/2000
20. Indicate the types of appointment(s) you will
accept:
Full-Time, Part-Time
21. Indicate the geographic areas where you are
willing to work.
South Central Los Angeles
22. Indicate the department(s) for which you will
accept employment.
Police - Civilian
23. Indicate your availability for the following shifts.
Day
24. Did you list any unpaid positions on this
employment application?
No
25. If you answered "yes" to the previous question,
please list the name of the organization, dates
employed and job title for all unpaid work in the
space provided below. If you answered "no" to
the previous question, please indicate N/A in the
space provided below.
N/A

Job Specific Supplemental Questions

1. To be PROPERLY AND PROMPTLY notified of
the status of my application, I UNDERSTAND
that I MUST provide on my City application, the
following information: -Working E-mail address -
Telephone Number -Official social security
number I UNDERSTAND that I MUST provide a
working email address on my application where
I will receive notifications regarding the status of
my application and the selection process. I
UNDERSTAND that important information
regarding the status of my application and the
selection process will only be sent via E-MAIL to
the email address I provided. I UNDERSTAND
that it is MY RESPONSIBILITY to ensure that the
email address I provided is a working email and
that I will check my email regularly to ensure I
receive any communication as it relates to the
examination promptly. I UNDERSTAND that the
City of Los Angeles Personnel Department is
NOT RESPONSIBLE for any lost or redirected
emails and that it is MY RESPONSIBILITY to add
[email protected] to my email contact
list to avoid email notifications related to this
examination from being classified as "spam" or
"junk" mail.
I have read these statements to their fullest and will
provide a working e-mail address on my application
in order to receive status of my application
regarding this examination.
2. I UNDERSTAND that I am required to describe,
IN DETAIL, my appropriate qualifying experience
in the Work Experience Section of my
application. I UNDERSTAND that if I attach a
resume and/or cover letter IN LIEU of
completing the Work Experience Section, my
application is INCOMPLETE and WILL NOT be
considered for this examination, and my
application WILL NOT be further processed. In
addition to including my qualifying experience, I
UNDERSTAND that I should list ALL jobs,
STARTING WITH THE JOBS THAT WILL QUALIFY
ME FOR THIS EXAMINATION regardless of
duration, including part-time jobs, military
service and any periods of unemployment during
my entire work history.
I have read these statements to their entirety and
understand them completely and to their fullest.
3. I am currently:
Not employed with the City of Los Angeles.
4. I understand that I must be 18 years of age at
the time of appointment but may take the
Personal Qualifications Essay (PQE) if I am at
least 17 year of age.
Yes, I understand that I must be 18 years of age at
the time of appointment but may take the Personal
Qualifications Essay (PQE) if I am at least 17 year of
age.
5. I am currently enrolled in the Police Orientation
and Preparation Program (POPP) and have a
letter of recommendation from the LAPD
Personnel Section. Note: Applicants must
submit a letter of recommendation from the
LAPD Personnel Section at the time of filing. The
copy of the letter of recommendation must be
attached to the online application BEFORE the
application is submitted. If the letter of
recommendation is attached AFTER the online
application has been submitted, it will not be
available to the City and applicants WILL NOT be
credited with having submitted it. Applicants
who fail to submit the letter of recommendation
at the time of filing by attaching it to the online
application will not be considered further in this
examination.
This statement does not apply to me.
6. I have graduated from the Police Orientation and
Preparation Program within the last 12 months
and have a letter of recommendation from the
LAPD Personnel Section. Note: Applicants must
submit a letter of recommendation from the
LAPD Personnel Section at the time of filing. The
copy of the letter of recommendation must be
attached to the online application BEFORE the
application is submitted. If the letter of
recommendation is attached AFTER the online
application has been submitted, it will not be
available to the City and applicants WILL NOT be
credited with having submitted it. Applicants
who fail to submit the letter of recommendation
at the time of filing by attaching it to the online
application will not be considered further in this
examination.
This statement does not apply to me.
7. I have graduated from a Police Academy Magnet
School Program within the last two years and
have a letter of recommendation from the LAPD
Personnel Section. Note: Applicants must
submit a letter of recommendation from the
LAPD Personnel Section at the time of filing. The
copy of the letter of recommendation must be
attached to the online application BEFORE the
application is submitted. If the letter of
recommendation is attached AFTER the online
application has been submitted, it will not be
available to the City and applicants WILL NOT be
credited with having submitted it. Applicants
who fail to submit the letter of recommendation
at the time of filing by attaching it to the online
application will not be considered further in this
examination.
This statement does not apply to me.
8. I am currently participating in the LAPD Cadet
Program and have a letter of recommendation
from the LAPD Personnel Section. Note:
Applicants must submit a letter of
recommendation from the LAPD Personnel
Section at the time of filing. The copy of the
letter of recommendation must be attached to
the online application BEFORE the application is
submitted. If the letter of recommendation is
attached AFTER the online application has been
submitted, it will not be available to the City and
applicants WILL NOT be credited with having
submitted it. Applicants who fail to submit the
letter of recommendation at the time of filing by
attaching it to the online application will not be
considered further in this examination.
Yes, I am currently participating in the LAPD Cadet
Program and have a letter of recommendation from
the LAPD Personnel Section.
9. I understand that I must attach my letter of
recommendation from the LAPD Personnel
Section to this application. If I do not attach my
letter of recommendation from the LAPD
Personnel Section to this application, I will NOT
be considered further for Associate Community
Officer.
Yes, I understand that I must attach my letter of
recommendation from the LAPD Personnel Section
to this application. If I do not attach my letter of
recommendation from the LAPD Personnel Section
to this application, I will NOT be considered further
for Associate Community Officer.
10. The following section is part of the Associate
Community Officer Job Preview Questionnaire.
Please read the following instructions to ensure
you complete the Job Preview Questionnaire as
required.
I understand this information.
11. City of Los Angeles Personnel Department
ASSOCIATE COMMUNITY OFFICER - 2017
(Class Code 2210) JOB PREVIEW
QUESTIONNAIRE The City of Los Angeles
strives to hire the best candidate for every
position. Our goal is to fill each job with a
person who is well qualified, has an interest in
the job, and who will be committed to a career in
that field. To do this, it is important for
applicants to have a realistic understanding of
the job. If any of these conditions present a
problem for you, we suggest you consider
alternate employment choices that may better fit
your career goals.
I understand the information provided above.
12. Question #1 I understand that appointments will
be made to temporary training positions in
accordance with Section 5.30 of the Rules of the
Board of Civil Service Commissioners, for a
maximum duration of five years. In order to
successfully complete the temporary training
period, it is expected that new appointees will
transition to Police Officer within 30 months.
Yes
13. Question #2 I understand that after applying for
Police Officer, I will be expected to appear for all
Police Officer Test Parts.
Yes
14. Question #3 I will voluntarily attend the
Candidate Advancement Program (CAP) at least
once per month, as this will lead to my ability to
become a Police Officer and succeed in the
Police Academy.
Yes
15. Question #4 I will voluntarily take the Physical
Fitness Qualifiers at least once at CAP.
Yes
16. Question #5 I will voluntarily attend an Oral Prep
Seminar to prepare me for the Police Officer
Department Interview.
Yes
17. Question #6 While employed as an Associate
Community Officer, I understand that I will be
required to attend a Police Officer Meet and
Greet.
Yes
18. Question #7 While employed as an Associate
Community Officer, I understand that I will be
required to complete at least one Ride-Along.
Yes
19. Question #8 While employed as an Associate
Community Officer, I understand that I will be
expected to maintain monthly communication
with my Police Officer Mentor or Associate
Community Officer Program Coordinator.
Yes
20. Question #9 I am willing to work at all locations,
under all types of conditions, with all types of
people.
Yes
21. Question #10 I am willing to be present in
situations involving combative suspects, crowd
control, CPR and first aid.
Yes
22. Question #11 I am willing to fill out many forms,
logs, and reports.
Yes
23. Question #12 I am willing to adhere to any
established dress code with specifics in regards
to grooming and physical appearance.
Yes
24. Question #13 I understand and accept that this
job requires me to maintain a clear head, a
positive attitude, and a solid work ethic while
working under a great deal of pressure, enduring
substantial criticism at times, and dealing with
people who are upset, angry, and/or hostile.
Yes
25. This completes the Job Preview Questionnaire
for Associate Community Officer. Review your
responses to ensure you have included all
required information.
I understand this statement

Before submitting your application, please make

sure you have entered your correct e-mail address
and completed your Work Experience, which
MUST INCLUDE:
Duties Performed
By clicking on the 'Accept' button, I hereby certify
that every statement I have made in this application
is true and complete to the best of my knowledge. I
understand that any false or incomplete answer may
be grounds for not employing me or for dismissing
me after I begin work. I understand that I will have to
produce documentation verifying identity and
employment eligibility in the U.S. I understand that I
may be required to verify any and all information
given on this application. I understand that this
completed application is the property of the City of
Los Angeles and will not be returned. I understand
that the City of Los Angeles may contact prior
employers and other references. I understand that I
must notify the Employment Services Section of any
changes in my name, address, or phone number.

I understand that if I am scheduled to participate

in any test part of the examination, I MUST have
a valid, unexpired photo identification card with me
at the test location in order to be tested. If I do not
have a valid, photo identification card with me, I
WILL NOT be allowed to take the test and will be
DISQUALIFIED in this examination.

If your application is approved to participate further

in this examination, upon receiving your test notice,
please refer to it for specific test instructions.

I understand that I may be required to verify any and

all information given on this application. I
understand that this completed application is the
property of the City of Los Angeles and will not be
returned. I understand that the City of Los Angeles
may contact prior employers and other references. I
understand that I must notify the Personnel
Department of any changes in my name, address, or
phone number.

This application was submitted by Rivera,

Jacqueline Valeria on 11/20/2018 01:59 PM

Signature________________________________________________________________
Date_____________________________________________________________________