Resume Sheet For Registered Deputy Inspector Form
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1
2RESUM E SHEET
REGISTERED DEPUTY INSPECTOR
FOR
N AM E: __________________________________________________B IRT H D AT E: _____________D AT E: _____________
T ELE PH O N E #: _______________CE LL PH O N E #: _______________E-M AIL: ___________________________________
[ ]
N EW AP PLICAN T
[ ] RE N EW AL AP PLICAN T
(LICE N SE #______________________)
T YP E OF EX AM INATION:
[ ] SC [ ] C C [ ] M C [ ] W D [ ] SO [ ] SF R M [ ] M E T [ ] SM K [ ] SR [ ] W R [ ] P SC [ ] D IA [ ] G U [ ] E FIS
E DUC ATION AND EXP E RIE NCE
LA ST GR A DE C OM PLETED:
DID YOU GRA DUATE?
If Not, have you passed the GE D?
Name & location of schools
Dates attended
Degree /
Seminars or
Duration / H ours
Certificate /
Provide copy
Provide copy
C on-E d C lasses
From:
To :
From:
To :
From:
To :
From:
To :
EXP ERIENC E: Begin with your most recent job, then list each job separately. List all jobs and any periods of unemployment in
the past 10 -years. List any jobs you held more than 10-years ago which relate to the deputy certification you are app lying for and
indicate the amount of time performing that function. Include any military service.
D A TES
EM PLO Y ER
D U TIES
M O N T H & Y E AR
N AM E O F P R E V IO U S E M P L O Y E R
Y O U R TIT L E :
F R O M
T O
D U TIE S :
AD D R E S S
T OT AL
Y E A R S
M O N T H S
C IT Y, S T A T E A N D Z IP C O D E
EM PLO Y ER S TE LEPH O N E #:
D A TES
EM PLO Y ER
D U TIES
M O N T H & Y E AR
N AM E O F P R E V IO U S E M P L O Y E R
Y O U R TIT L E :
F R O M
T O
D U TIE S :
AD D R E S S
T OT AL
Y E A R S
M O N T H S
C IT Y, S T A T E A N D Z IP C O D E
EM PLO Y ER S TE LEPH O N E #:
As a covered entity under 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 accommodation to ensure equal access to its programs, services and activities.
IN.Form.50 Dep Exam (Rev. 03-29-2016)
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