NAME _______________________________ _______________________________ _____
Last First M.I.
PRESENT ASSIGNMENT LOCATION ___________________________________________________
PRESENT CLASSIFICATION (circle one) GS I GS II GS III ISM
Start date for current GS classification ____/____/_____
Start date for San Mateo County ____/____/______
LANGUAGE(S) FOR WHICH YOU ARE RECEIVING BILINGIUAL PAY ___________________________________________________________________
SPECIAL SKILLS AND ABILITIES AND APPLICABLE TRAINING YOU POSSESS (continue on back of page if needed ) ____________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
ASSIGNMENT PREFERENCE
YSC: Mental Health Unit, Behavior Management/ Flex unit, Intake/ Probation Management, Post Court Housing Younger Boys, Post Court Housing Older Boys, Girls Unit, Kemp Girls Program, Camp Glenwood, Transportation Unit
JUVENILE PROBATION SERVICES: Placement Unit, Juvenile Drug Courts, Preventing Repeat Offender Program
Family Preservation Programs
ADULT PROBATION SERVICES DIVISION: Bridges
1. ___________________________ 2. ____________________________ 3. __________________________
PREFERRED SHIFT PATTERN
1. ___________________________ 2. ___________________________ 3. _______________________
SIGNATURE __________________________________________________ DATE __________________
Comments (use back of page or attach page if needed) _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Mangement Team Review: (Is employee capable of performing/ learning requested assignments? If not, what training, experience, skills required? ) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
YSC Assignment:_____________________________________________________________________