Page 98 - SAC - DPW - AMB 09 05 19

EMPLOYMENT APPLICATION
CITY OF SACRAMENTO Received;
915 I Street, Historic City Hall
SA\CR,AM ENT'D
Sacramento, California 95814-2604
(916) 808-5726
https://www.cityofsacramento.org/HR
Department of , !uma- Resources
QUESTIONS WITH AN * REQUIRE A RESPONSE, YOUR APPLICATION MAY NOT BE CONSIDERED IF INCOMPLETE.

020021 Director of Public Works
* POSITION TITLE:
JOB POSTING NUMBER:
PERSONAL INFORMATION
• FIRST NAME MIDDLE INITIAL * LAST NAME
Fritz Buchman
• ADDRESS
9728 Club Park Drive
• CITY * STATE I * ZIP
I
Elk Grove CA 95757
HOME PHONE ALTERNATE PHONE
209-482-6339
* WHICH METHOD DO YOU PREFER TO BE NOTIFIED ABOUT YOUR
* EMAIL ADDRESS APPLICATION STATUS? j EMAIL OR
D PAPER
buchmans@comcast.net
EDUCATION
WHAT IS YOUR HIGHEST LEVEL OF EDUCATION:
Some High School some College
E3 0 0 Associates Degree 0 Master's Degree
O Bachelor's Degree
0 Doctorate
High School 0 Technical College
LEGAL RIGHT TO WORK
CAN YOU, AFTER EMPLOYMENT, SUBMIT PROOF OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES? YES li 0
NO
EDUCATION
SCHOOL NAME DEGREE RECEIVED
University of California, Davis Bachelor of Science
QUARTER
0 SEMESTER
SCHOOL LOCATION (CITY/STATE) I DID YOU GRADUATE?
# OF UNITS COMPLETED:
NO
Davis, CA YES 11 0
200
MAJOR
Civil Engineering
SCHOOL NAME DEGREE RECEIVED
0
O SEMESTER QUARTER
SCHOOL LOCATION (CITY/STATE) I DID YOU GRADUATE?
# OF UNITS COMPLETED:
YES 0
NOD
MAJOR
SCHOOL NAME I DEGREE RECEIVED
0 QUARTER
0 SEMESTER
SCHOOL LOCATION (CITY/STATE) DID YOU GRADUATE? # OF UNITS COMPLETED:
YES 0
NOD
MAJOR
DRIVER'S LICENSE INFORMATION
F
STATE WHERE ASS
CL
YES
* IF THE POSITION INVOLVES DRIVING, DO YOU HAVE A VALID LICENSE? I I ISSUED
NOD
0
[CA
CERTIFICATES & LICENSES
TYPE DATE ISSUED (MONTH/YEAR) EXPIRATION DATE (MONTH/YEAR)
CA Professional Engineer. Civil 021 2000 0612020
LICENSE NUMBER ISSUING AGENCY
CA Dept. of Consumer Affairs
C60418
TYPE 1 DATE ISSUED (MONTH/YEAR) EXPIRATION DATE (MONTH/YEAR)
0312016
CA Professional Engineer. Traffic [ _06/2020
LICENSE NUMBER 1 I6SUING AGENCY
CA Dept of Consumer Affairs
TR2793 J