Std 678 Form – Fill Out and Use This PDF

The State of California's State Personnel Board Examination/Employment Application, known as STD. 678, is a comprehensive document used for the process of applying for examinations and employment within state departments. It requires detailed information from applicants, including personal identification, employment history, educational background, and specific questions related to employment and examination eligibility. For those interested in state employment or seeking to participate in examinations for state positions, completing the STD. 678 form accurately is a critical step. Click the button below to start filling out your form.

Get Form Now Download PDF

Std 678 Form PDF Details

The State of California has designed the State Personnel Board Examination/Employment Application, STD. 678, as a comprehensive form for individuals seeking employment or aiming to take part in examinations for state positions. Revised in June 2010, this document serves multiple purposes, from capturing basic applicant information to detailing employment history and educational background. Applicants are required to provide a wide array of data, including their contact information, job titles they're applying for, and detailed records of their previous employment. Additionally, the form addresses several preliminary questions about an applicant's eligibility for accommodations, religious considerations, employment status with the state, and any previous terminations or disciplinary actions. To support positions requiring specific qualifications, applicants are prompted to list languages they are fluent in, typing speed (if applicable), possession of a California Driver License, and any other licenses or certifications relevant to the job. The form emphasizes the importance of truthfulness by requiring a certification signed under penalty of perjury, ensuring all provided information is accurate. Moreover, it includes an Equal Employment Opportunity section aimed at gathering demographic information for statistical and research purposes, making it clear that this data will not be used in hiring decisions. The STD. 678 form, therefore, stands as a critical initial step for anyone looking to enter or progress within the California state workforce, balancing thorough applicant screening with respect for equal employment opportunities.

Question	Answer
Form Name	Std 678 Form
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	false, easy id, YY, where to get easy id in form std 678

Form Preview Example

STATE OF CALIFORNIA — STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 1

Applications will be processed ONLY for classifications where an examination is in progress and the published final filing date has not passed, or for vacant positions where a department requests an application.

PRINT OR TYPE — PLEASE SEE INSTRUCTIONS ON BACK PAGE

APPLICANT IDENTIFICATION NUMBER (EASY ID)

EASY ID

FIRST 3 LETTERS OF

MONTH OF BIRTH

DAY OF BIRTH

LAST 4 DIGITS OF SOCIAL

LAST NAME AT BIRTH

SECURITY NUMBER

APPLICANT'S NAME (Last)

(First)

(M.I.)

SOCIAL SECURITY NUMBER

MAILING ADDRESS (Number)

(Street)

E-MAIL ADDRESS

WORK TELEPHONE NUMBER

(City)

(County)

(State)

(Zip Code)

HOME/VRS/TTY TELEPHONE NUMBER

EXAMINATION(S) OR JOB TITLE(S) FOR WHICH YOU ARE APPLYING

PERSONNEL

USE ONLY

ANSWER THE FOLLOWING QUESTIONS:

1.Enter the county in which you would like to take the examination if different from the county of your residence:

2. Do you need reasonable accommodation to take an interview or written test?

3. Do your religious beliefs prevent you from taking an examination on Saturday?

4. Are you now employed by the State of California? (If "YES", fill in the information below.)

Department:Subdivision:

5. Have you ever been fired, dismissed, terminated, or had an employment contract terminated from any position for performance or for disciplinary reasons? (Applicants who have been rejected during a probationary period, or whose dismissals or terminations have been overturned, withdrawn [unilaterally or as part of a settlement agreement] or revoked need not answer "Yes".) Refer to the Instructions for further information. If "Yes" to Question #5, give details in the Explanations section.

6.In addition to English, list any other languages you:

a.possess verbal fluency in

b.possess written fluency in

7. I certify I can type at a speed of

words per minute. (For typing applicants only.)

YES

(ANSWER QUESTIONS 8 AND 9 ONLY IF THE EXAMINATION INDICATES THEY ARE REQUIRED.)
8.	Do you meet the minimum and/or maximum age requirements?			YES	NO
9.	Do you possess a valid California Driver License? (If "YES", fill in the information below.)			YES	NO
	License#	Class:	Restrictions:

EXPLANATIONS

CERTIFICATION – IMPORTANT – PLEASE READ BEFORE SIGNING – If not signed, this application may be rejected.

I certify under penalty of perjury that the information I have entered on this application is true and complete to the best of my knowledge. I further understand that any false, incomplete, or incorrect statements may result in my disqualification from the examination process or dismissal from employment with the State of California. I authorize the employers and educational institutions identified on this application to release any information they may have concerning my employment or education to the State of California.

APPLICANT'S SIGNATURE

DATE SIGNED

APPLICANTS—DO NOT USE THE SPACE BELOW—FOR PERSONNEL USE ONLY

Classes	01	02	03	04	05	06

WC for

Series/Levels

RC/Flag for

Series/Levels

Flags

FOR PERSONNEL USE ONLY

STATUS
ACCEPTED	REJECTED WC

EXPERIENCE	LICENSE REQUIREMENT

CODES

EDUCATION

OTHER

STAFF

DATE PROCESSED

STATE OF CALIFORNIA — STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 2

APPLICANT'S NAME (Last)

(First)

(M.I.)

EASY ID

EDUCATION

DID YOU GRADUATE FROM HIGH SCHOOL?

IF NOT, DO YOU POSSESS A GED OR EQUIVALENT?

IF NOT, ENTER THE HIGHEST GRADE YOU COMPLETED

YES

UNIVERSITY OR COLLEGE—NAME AND LOCATION,

UNITS COMPLETED

DIPLOMA, DEGREE OR

DATE

BUSINESS, CORRESPONDENCE, TRADE OR

COURSE OF STUDY

CERTIFICATE OBTAINED

COMPLETED

SERVICE SCHOOL

SEMESTER

QUARTER

LICENSES – LIST APPLICABLE LICENSES AND CERTIFICATES INDICATED IN THE EXAMINATION BULLETIN.

(If you are an attorney, please indicate the date you were admitted to the Bar under the Issue Date column, if stated on the examination bulletin.)

LICENSE/CERTIFICATION NUMBER	ISSUE DATE	EXPIRATION	IN THE SPACE BELOW, INDICATE SPECIFIC COURSE REQUIREMENTS NEEDED
LICENSE/CERTIFICATION NUMBER	ISSUE DATE	DATE	TO SATISFY REQUIREMENTS FOR THIS EXAMINATION
		DATE	TO SATISFY REQUIREMENTS FOR THIS EXAMINATION

EMPLOYMENT HISTORY– Begin with your most recent job. List each job separately.

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months) COMPANY/STATE AGENCY NAME		SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

STATE OF CALIFORNIA — STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 3

APPLICANT'S NAME (Last)

(First)

(M.I.)

EASY ID

EMPLOYMENT HISTORY (Continued)

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months) COMPANY/STATE AGENCY NAME		SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

STATE OF CALIFORNIA — STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 4

APPLICANT'S NAME (Last)

(First)

(M.I.)

EASY ID

EMPLOYMENT HISTORY (Continued)

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

FROM (MM/DD/YY)	TO (MM/DD/YY)	TITLE/JOB CLASSIFICATION (Include Range or Level, if applicable)	SUPERVISOR NAME

HOURS PER WEEK	TOTAL WORKED (Years/Months)	COMPANY/STATE AGENCY NAME	SUPERVISOR PHONE NUMBER

SALARY EARNED		ADDRESS

$PER

DUTIES PERFORMED

REASON FOR LEAVING

STATE OF CALIFORNIA — STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 5

EQUAL EMPLOYMENT OPPORTUNITY

(For Examination Use Only)

APPLICANT: To assist the State of California in its commitment to Equal Employment

Opportunity, applicants are

asked to

voluntarily provide the following information. This

questionnaire

will

be separated from the application prior to the examination and

will not be used in any employment decisions. Government

Code

Section 19705 authorizes

the State Personnel Board

to retain

this information for research and statistical purposes.

APPLICANT IDENTIFICATION NUMBER (EASY ID)

EASY ID

FIRST 3 LETTERS OF

MONTH OF BIRTH

DAY OF BIRTH

LAST 4 DIGITS OF SOCIAL

LAST NAME AT BIRTH

SECURITY NUMBER

AGE

GENDER

(1) UNDER 21

(3) 21 - 39

(6) 40 - 69

(7) 70 AND OVER

MALE

FEMALE

Ethnic Category (Please check the box that best describes your race/ethnicity.):

(7)AMERICAN INDIAN OR ALASKAN NATIVE—Persons having origins in any of the tribal peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.

ENTER TRIBAL IDENTIFICATION OR AFFILIATION

(2)ASIAN—Persons having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent. This includes China, Japan, and Korea.

(1)

(8)

(4)

(6)

(5)

BLACK—Persons having origins in any of the black racial groups of Africa.

FILIPINO—Persons having origins in any of the original peoples of the Philippine Islands.

HISPANIC—Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

PACIFIC ISLANDERS—Persons having origins in the Pacific Islands, such as Samoa.

WHITE—Persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

Check if:

(3)

OTHER (Specify)

(Y)DISABLED—A person with a disability is an individual who: (1) has a physical or mental impairment or medical condition that limits one or more life activities, such as walking, speaking, breathing, performing manual tasks, seeing, hearing, learning, caring for oneself or working; (2) has a record or history of such impairment or medical condition; or (3) is regarded as having such an impairment or medical condition.

MILITARY—A military veteran; a widow or widower of a veteran; or a spouse of a 100% disabled veteran.

How did you learn of this Examination?

TELEPHONE JOB LINE

WORD OF MOUTH

INTERNET

ADVERTISEMENT IN

EXAMINATION BULLETIN LOCATED AT

THANK YOU FOR COMPLETING THIS QUESTIONNAIRE

STATE OF CALIFORNIA - STATE PERSONNEL BOARD

EXAMINATION/EMPLOYMENT APPLICATION

STD. 678 (REV. 6/2010) Page 6

INSTRUCTIONS

Read the following instructions carefully before completing this Application. Please complete the Application on a typewriter or personal computer or print in ink. All questions must be answered completely and accurately, except as noted. You may be disqualified for any false or misleading statements or for omitting information. The information you furnish will be used to determine your eligibility and/or may be the basis for arriving at your final rating in an examination. During the course of an examination, you may be requested to provide additional information regarding your qualifications, your preference regarding work location, shifts, etc.

Easy ID - You are required to provide the following tracking information on the application. The first three letters of your last name at birth, the month and day of your birth and the last four digits of your social security number. If you have already established an Easy ID in the online system and it is different, please provide that Easy ID.

Social Security Number - Providing this is voluntary in accordance with the Privacy Act of 1974 (PS 93-579). However, if the Social Security Number is not provided, the department administering this examination will be unable to process your application for purposes of granting Veteran's Preference points, Career Credits, written test waivers, or to check for eligibility in promotional examinations.

Home/VRS/TTY Number - Provide your 10-digit home telephone, Video Relay Service (VRS) phone number, or Text Telephone (TTY) phone number.

Examination Title/Job Title - Fill in the exact title of the examination from the examination bulletin. Promotional examinations are only available to those who currently meet the criteria to apply on a promotional basis (i.e., civil service employee, veteran, legislative employee, etc.). If applying for a vacant position, enter the class title of the position/vacancy for which you are applying.

Question 2 - Reasonable Accommodation will be provided to applicants who need assistance to take an interview or written test. If you check “Yes” you will be contacted via telephone or mail to make specific arrangements.

Question 5 - Employment History/Discharges. Question 5 must be answered by all applicants. You must answer “Yes” if you have ever, because of poor performance or misconduct, been fired, dismissed, or terminated from a job, or had an employment contract terminated. Explain any “Yes” answers in the Explanations section. Include the facts in brief, the grounds for any action taken against you, and the circumstances under which you left the position.

In completing this application, you do not need to answer “Yes” to Question 5 if:

•you have been rejected during a probationary period; or

•your employer withdrew the firing, dismissal, termination, or contract termination (either voluntarily or as part of a settlement); or

•a court or administrative agency overturned or revoked the firing, dismissal, termination, or contract termination.

If asked about past employment history by a prospective employer during the hiring process or probationary period, however, applicants are required to tell the truth regarding any firing, dismissal, termination, contract termination or rejection during probationary period, whether or not the action was overturned, revoked, or withdrawn (either voluntarily by the employer or, as part of a settlement agreement). Applicants are also required to provide factually correct information on the Employment History section of the application.

Questions 8 and 9 - These questions should be answered only if the examination bulletin indicates (a) a minimum or maximum age requirement for eligibility; and/or (b) a California Driver License requirement.

Explanations - Use this section to explain the details of any response that requires additional information. Be thorough, and attach additional sheet(s) if needed.

Signature - Your signature and the date signed is required. If the Application is not signed, it may be rejected.

Education - You must include a complete record of your training and educational background. Please read the Requirements section of the examination bulletin carefully for any special educational requirements. If more space is needed, attach additional sheet(s).

Licenses - If the examination bulletin calls for a specific license, professional certificate, or membership in a professional organization, list the full name of the license, certificate or organization, the license number, and the official expiration date of the document or membership.

Experience - You must include a complete list of your paid and/or volunteer work experience which relates to the qualification requirements specified on the examination bulletin. List all relevant jobs, during the past 10 years, regardless of duration, including part-time and military service. You should also list volunteer experience and jobs held more than ten years ago if they relate directly to the job for which you are applying.

State employees must list the specific departments for which they worked and indicate the specific civil service class title(s) held.

Examinations Granting Veteran’s Preference Points - If you have not previously applied for and been approved Veteran’s Points, you must apply for the points by completing and submitting the Application for Veteran’s Preference Form SPB-1093 to the State Personnel Board.

NOTE: Your completed Application and other examination related information submitted to the department administering this examination becomes confidential information and the property of the State of California as provided by Government Code Section 18934. This Application and other confidential information will not be returned; therefore, we recommend that you keep a copy of your completed Application for your personal records. Your rights to inspect your examination papers are set forth in Sections 186-189 of Title 2 of the California Code of Regulations, which can be accessed on the State Personnel Board’s website at www.spb.ca.gov.

PLEASE ENTER YOUR NAME ON PAGES 1 THROUGH 4 AND STAPLE ALL PAGES OF THE APPLICATION

TOGETHER BEFORE SUBMITTING!

How to Edit Std 678 Form Online for Free

fluency can be completed online very easily. Just make use of FormsPal PDF tool to complete the job right away. Our expert team is continuously working to expand the editor and make it much easier for people with its many functions. Take advantage of present-day innovative opportunities, and discover a heap of new experiences! If you are seeking to begin, this is what it takes:

Step 1: Simply hit the "Get Form Button" at the top of this site to launch our pdf file editing tool. This way, you'll find everything that is necessary to fill out your document.

Step 2: With the help of our advanced PDF tool, it is easy to do more than merely fill out blanks. Try all of the functions and make your documents seem great with custom textual content incorporated, or fine-tune the original content to perfection - all that comes along with an ability to insert any kind of graphics and sign the file off.

For you to finalize this document, be certain to type in the required information in every single field:

1. When completing the fluency, be certain to complete all important blanks in their relevant area. This will help to expedite the work, allowing your information to be handled fast and properly.

2. Your next stage is to fill out these particular fields: Have you ever been fired dismissed, In addition to English list any, a b, possess verbal fluency in possess, I certify I can type at a speed of, ANSWER QUESTIONS AND ONLY IF THE, Do you possess a valid California, in the information below, License Class Restrictions, EXPLANATIONS, YES, YES, CERTIFICATION IMPORTANT PLEASE, I certify under penalty of perjury, and APPLICANTS SIGNATURE.

ANSWER QUESTIONS AND ONLY IF THE, In addition to English list any, and License Class Restrictions of VRS

Be really careful when filling out ANSWER QUESTIONS AND ONLY IF THE and In addition to English list any, because this is the section where many people make errors.

3. Completing APPLICANTS NAME Last, First, EASY ID, EDUCATION DID YOU GRADUATE FROM, IF NOT DO YOU POSSESS A GED OR, IF NOT ENTER THE HIGHEST GRADE YOU, YES, YES, UNIVERSITY OR COLLEGENAME AND, BUSINESS CORRESPONDENCE TRADE OR, SERVICE SCHOOL, COURSE OF STUDY, UNITS COMPLETED, SEMESTER, and QUARTER is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

4. To go ahead, this form section involves typing in a few fields. These include HOURS PER WEEK, TOTAL WORKED YearsMonths, COMPANYSTATE AGENCY NAME, SUPERVISOR PHONE NUMBER, SALARY EARNED, DUTIES PERFORMED, PER, ADDRESS, REASON FOR LEAVING, FROM MMDDYY, TO MMDDYY, TITLEJOB CLASSIFICATION Include, SUPERVISOR NAME, HOURS PER WEEK, and TOTAL WORKED YearsMonths, which you'll find vital to carrying on with this process.

5. The document has to be finished by filling in this part. Further there is a full set of form fields that need specific details for your form usage to be complete: DUTIES PERFORMED, and REASON FOR LEAVING.

REASON FOR LEAVING, DUTIES PERFORMED, and REASON FOR LEAVING in VRS

Step 3: Spell-check what you have typed into the blank fields and click the "Done" button. Sign up with FormsPal now and instantly gain access to fluency, ready for downloading. All adjustments made by you are saved , letting you modify the form further if needed. We do not share or sell the information that you type in when dealing with forms at our website.

Std 678 Form – Fill Out and Use This PDF

Std 678 Form PDF Details

Form Preview Example

How to Edit Std 678 Form Online for Free

Std 678 Form isn’t the one you’re looking for?

Related Documents