UCI Candidate Self-Service

Displayed below is your current application. Please review each section carefully and select Click Here to Edit if modifications are needed. Click Submit at the bottom of the application when finished.

Position Applied For

Position Title:	Program Representative
Department:	Social Ecology II
Req No.:	2013-1166
Location:	UCI Campus - Irvine

Contact Information [Click Here to Edit]
Enter your contact information. Remember to click Save Changes when you are finished.
* Last Name:	Cabrera
* First Name:	Blas Jacob
Middle Initial(s):
* Address 1:	705 Alvarado Row
Address 2:
* City:	Stanford
* State (ST):	CA
* Zip/Postal Code:	94305
Email:	jacobcabrera@icloud.com
* Home Phone(###-###-####):	831-332-2486
Work Phone(###-###-####):
* How did you hear about employment at UCI?	Professional Website
* = Required Field.

Education [Click Here to Edit]

In the spaces below, please enter schools you have attended, degrees received, and your primary area of study.

	* School/City	From MM/YY	To MM/YY	Degree Received	* Major
* 1.	University of California at Santa Cruz	09/1998	06/2004	Bachelor	Environmental Studies and Biology

This section requires a minimum of 1 entry.
* = Required Field.

Professional Licenses and Certificates [Click Here to Edit]
Please enter any professional licenses and certifications which you currently hold or have recently held.
No Information Available.

Work History [Click Here to Edit]
Please enter your employment history, including your present employer. When you click Save Changes, entries will be sorted by the ‘From’ date with your most recent listed first.
* Employer 1
* Employer:	eBay Inc.
City/State:	San Francisco
* Job Title:	Ad Operations Specialist Level II
Duties (Max 1000 characters):	Primary duties involved purchasing and delivering packages to customers. Additional duties included training of new valets, marketing and promotions, and working directly with senior engineers in San Jose to improve iPhone application.
* From Date (MM/YY):	06/2012
To Date (MM/YY):	10/2013
* Beginning Salary:	$15,000.00
Ending Salary:	$20,000.00
* Reason for leaving:	The position did not match my expectations, overall values, nor my career goals moving forward.
* Supervisor/Title:	Heidi Armstrong
Phone(###-###-####):	415-205-4645
* May we contact this employer:	(*) Yes ( ) No
This section requires a minimum of 1 entry. * = Required Field.

Employer 2
* Employer:	Unity Network
City/State:	Stanford, Ca
* Job Title:	Executive Director
Duties (Max 1000 characters):	Founded a 501c3 non-profit organization called the Community Life Network, Inc. (CLN). As an umbrella organization, CLN supports a variety of projects that help solve problems of the 21st Century with principles rooted in sustainability, grassroots activism, and collaboration. Over the last 2-3 years, the primary focus of the network has been proposing and developing proposals for economic systems based on natural ecology and sustainability. A variety of projects relating to this have been collaborated on with a variety of other non-profits and community organizations including Occupy during 2011, which has continued to be the largest movement. My role in supporting our umbrella projects is to coordinate our $20,000 programs budget, taxes, government filings, communications, web pages, and general management of the non-profit. Other projects include Digital Storytellers, which
* From Date (MM/YY):	01/2006
To Date (MM/YY):
* Beginning Salary:	$1.00
Ending Salary:	$1.00
* Reason for leaving:	Need a job that pays me, I've been volunteering too long.
* Supervisor/Title:	Mellisa Vo Board Member
Phone(###-###-####):	(917) 456-2040
* May we contact this employer:	(*) Yes ( ) No
This section requires a minimum of 1 entry. * = Required Field.

Employer 3
* Employer:	UC Santa Cruz
City/State:	Santa Cruz, Ca
* Job Title:	Sustainability Adviser
Duties (Max 1000 characters):	Established a $360,000 permanent annual budget for the Campus Sustainability Council. Advised and helped establish structures and processes to oversee the student budget for implementing sustainability programs including the establishment of the highest level sustainability committee to the chancellor and the foundation for the future creation of the Office of Sustainability at UC Santa Cruz.
* From Date (MM/YY):	06/2004
To Date (MM/YY):	10/2006
* Beginning Salary:	$15,000.00
Ending Salary:	$15,000.00
* Reason for leaving:	This was a temporary position that lasted until finalization of the structures and processes for the financial oversight of the sustainability programs.
* Supervisor/Title:	Joyce Rice, Sustainability Coordinator
Phone(###-###-####):	831-459-1714
* May we contact this employer:	(*) Yes ( ) No
This section requires a minimum of 1 entry. * = Required Field.

Employer 4
* Employer:	UC Santa Cruz
City/State:	Santa Cruz, Ca
* Job Title:	Internal Vice Chair Student Union Assembly & Chai
Duties (Max 1000 characters):	This was the number two position within the Student Government. Oversaw all internal programs including appointments of students to over one hundred campus wide committees. Simultaneously founded the Campus Sustainability Council and the Education for Sustainable Living Program.
* From Date (MM/YY):	06/2003
To Date (MM/YY):	06/2004
* Beginning Salary:	$8,000.00
Ending Salary:	$8,000.00
* Reason for leaving:	This was a 1-year, 1-term elected position.
* Supervisor/Title:	Sayo Fujioka Student Activities Director
Phone(###-###-####):	831-459-2934
* May we contact this employer:	(*) Yes ( ) No
This section requires a minimum of 1 entry. * = Required Field.

Employer 5
* Employer:	UC Santa Cruz
City/State:	Santa Cruz, Ca
* Job Title:	Chancellors Undergraduate Intern for the Natural
Duties (Max 1000 characters):	Worked directly with the Director of the Natural Reserves to help coordinate the UCSC Natural Reserve System. Duties included student recruitment and outreach, as well as administrative tasks, public speaking, grant writing, and project management.
* From Date (MM/YY):	06/2003
To Date (MM/YY):	06/2004
* Beginning Salary:	$8,000.00
Ending Salary:	$8,000.00
* Reason for leaving:	Internship only lasted for one year.
* Supervisor/Title:	Barbara Silverthorn
Phone(###-###-####):	(831) 459-4021
* May we contact this employer:	(*) Yes ( ) No
This section requires a minimum of 1 entry. * = Required Field.

Past UC Work Experience [Click Here to Edit]

Please enter your past UC work experience. Remember to click Save Changes when you are finished.

* Have you ever worked for the University of California?

If yes, please complete the following:

(*) Yes ( ) No

Have you been laid off from UC Irvine?

If yes,

( ) Yes (*) No

Are you a Preferential Rehire candidate for this recruitment?

( ) Yes ( ) No

Have you participated in a Voluntary Separation Program offered
by any UC Campus, Medical Center or National Laboratory?

If yes,

( ) Yes ( ) No

From what UC location(s):

What was the date of separation (MM/DD/YY):

This section is to be answered only by those that have retired from
the University of California (UC) which includes members who took
a Lump Sum Cashout as well as those who receive a
Monthly Retirement Income.

The UC requires employment offices to collect the following
information as it relates to the UC retiree hiring policy.
UC retirees may be rehired into positions at the UC
depending on selected payment options made at the time of
retirement. (For more information regarding the UC retiree
employment policy, please see
http://atyourservice.ucop.edu/.../re-emp_ret_emp.pdf)

Have you retired from the UC?

If yes,

What UC location did you retire from?

( ) Yes (*) No

Location:

Date (MM/DD/YY):

Are you currently receiving a UCRP monthly retirement income?

( ) Yes ( ) No

Did you receive a UCRP Lump Sum Cashout at the time of your retirement?

( ) Yes ( ) No

* = Required Field.

Military Service [Click Here to Edit]
Please enter your military service information. Remember to click Save Changes when you are finished.
Branch of Service:
Enlistment(MM/YY):
Discharge/Release(MM/YY):
Rank at Discharge:
Are you a member of the Reserves?	( ) Yes ( ) No
Are you an active member?	( ) Yes ( ) No
Reserves Branch:
Nature of duties and special training received:
Awards and decorations:

Relatives [Click Here to Edit]
Please list below any relatives currently working for UCI. Remember to click Save Changes when you are finished. Relatives are defined as a spouse, domestic partner, parent, child (including the child of a domestic partner), siblings, in-laws, step-relatives and relatives of a domestic partner. Please go to http://atyourservice.ucop.edu/employees/policies_employee_labor_relations/personnel_policies/spp21.html to review the UC Near Relative policy.
No Information Available.

Relatives [Click Here to Edit]

Please list below any relatives currently working for UCI. Remember to click Save Changes when you are finished.

Relatives are defined as a spouse, domestic partner, parent, child (including the child of a domestic partner), siblings, in-laws, step-relatives and relatives of a domestic partner. Please go to http://atyourservice.ucop.edu/employees/policies_employee_labor_relations/personnel_policies/spp21.html to review the UC Near Relative policy.

No Information Available.

References [Click Here to Edit]

In the spaces below, please list any references that you would like to use for any positions applied for. Please note that no reference will be contacted unless you are being considered for a position.

	* Name	Company	Address	* Telephone#/Email	* Nature of Relationship
1.	Matt St. Clair	Sustainability Manager, University of California Office of the President	1111 Franklin St, 6th Floor, Oakland, CA 94607-5200	510-287-3897	Professional Reference
2.	Lesley Wilcox	Environmental Protection Watershed Outreach Planner for Montgomery County, MD	101 Monroe Street, 6th Floor, Rockville, Maryland 20850,	(240) 777-7780	Professional Reference
3.	Katie Maynard	Sustainability Coordinator, UC Santa Barbara	1712 Ellison Hall, Santa Barbara, CA 93106	805-448-5111	Professional Reference
4.	Joyce Rice	Sustainability Programs Manager, University of California at Santa Cruz	College Eight Commons, Room 210, UC Santa Cruz, 1156 High St, Santa Cruz, CA 95064	831-459-1714	Professional Reference
5.	Auroa Winslade	Director of Sustainability, University of Hawaii	Office of Sustainability, Classroom Building 210, University of Hawaii at West Oahu, 91-1001 Farrington Highway, Kapolei, HI 96707	808-689-2317	Professional Reference

* = Required Field.

Please answer all questions
All Questions are Required

1.	* I have read the Essential Functions in the Job Description and can perform the duties of this position.	● Yes ○ No
* = Required Field.

Related Questions [Click Here to Edit]
Please answer the following questions. Remember to click Save Changes when you are finished.
* Are you a U.S. citizen, or can you provide evidence of your legal right to work in the U.S.?	(*) Yes ( ) No
* Have you ever been convicted of a federal crime as defined in 42 USC 1320a-7(I) or been excluded from participating in any federal or state healthcare program?	( ) Yes (*) No
* Have you ever been convicted of a misdemeanor or felony? You may omit: 1) Information concerning an arrest or detention that did not result in a conviction, and information concerning a referral to, and participation in, any pretrial or posttrial diversion program; and 2) Any conviction for which the record has been judicially ordered sealed, expunged, or statutorily eradicated (e.g., juvenile offense records sealed pursuant to Welfare and Institutions Code Sections 389 or 781, or Penal Code Sections 851.7 or 1203.45); any misdemeanor conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed pursuant to Penal Code Section 1203.4; 3) Any conviction for a nonviolent drug possession offense if you have successfully completed drug treatment and the court has set aside the conviction pursuant to Penal Code Section 1210.1(d). 4) Any conviction specified in Labor Code Section 432.8, which pertains to various marijuana offenses. A CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FROM EMPLOYMENT.	( ) Yes (*) No
* = Required Field.

Voluntary Survey [Click Here to Edit]

This form is voluntary and will be kept separate from your resume/application when it is processed. The information obtained is used for statistical reporting purposes only. Questions concerning information asked in these sections may be directed to Office of Equal Opportunity and Diversity at (949) 824-5594, or Human Resources at (949) 824-5210.

Sex:

●	Male
○	Female
○	I Choose Not to Respond

Ethnicity:
Are you Hispanic or Latino?

○	No, not Hispanic or Latino.
●	Yes, Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish culture or origin, regardless of race.
○	I Choose Not to Respond

Race:
If not Hispanic or Latino, please select one of the following race categories.

●	White (Not Hispanic or Latino) A person having origins in any of the original peoples of Europe, the MiddleEast, or North Africa.
○	Black or African American (Not Hispanic or Latino) A persons having origins in any of the Black racial groups of Africa.
○	Asian (Not Hispanic or Latino) A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, The Philippine Islands, Thailand, and Vietnam.
○	Native Hawaiian or other Pacific Islander (Not Hispanic or Latino) A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
○	American Indian or Alaskan Native (Not Hispanic or Latino) A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
○	Two or More Races (Not Hispanic or Latino)
○	I Choose Not to Respond

Veteran:
(Please choose one of the options below if it describes your veteran status)

○	I am a veteran Please check all that apply:
	□ Recently Separated Veteran - Any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval or air service.
	□ Disabled Veteran - (1) A veteran of the U.S. military, ground, naval or air service who is entitled to disability compensation (or who but for the receipt of military retired pay would be entitled to disability compensation) under laws administered by the Secretary of Veterans Affairs; or (2) A person who was discharged or released from active duty because of a service-connected disability.
	□ War/Campaign Veteran - Any veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized. A list of qualifying wars, campaigns, and expeditions is available at http://www.opm.gov/veterans/html/vgmedal2.htm (Appendix A of the U.S. Office of Personnel Management VetGuide).
	□ Armed Forces Service Medal Veteran - Any veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 Fed. Reg. 1209).
	□ Veteran of the Vietnam Era - Any veteran who: (1) served on active duty for a period of more than 180 days and was discharged or released there from with other than a dishonorable discharge, if any part of such active duty occurred: (i) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (ii) between August 5, 1964 and May 7, 1975, in all other cases; or (2) was discharged or released from active duty for a service-connected disability if any part of such active duty was performed: (i) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (ii) between August 5, 1964 and May 7, 1975, in all other cases.
●	I am not a veteran
○	I Choose Not to Respond

Conditions of Employment

Conditions of Employment
Fair Labor Standards Act: Employees in positions which are designated in the University's Systemwide Title and Pay Plan as nonexempt shall be compensated for overtime either in cash or compensatory time off at the University's option in accordance with policy or contract provisions by which they are covered. Compensatory time at the premium rate may be preserved, used or cashed out in accordance with policy or contract provisions and section 7(0) of the Fair Labor Standards Act (Federal Wage and Hour Law). Loyalty Oath: U.S. citizens are required to sign a State of California Oath of Allegiance. Patent Acknowledgement: A patent acknowledgement must be signed upon employment.

Physical Exam: Employment at UCI Medical Center is contingent upon successful completion of a pre-employment physical examination. For other University positions, a physical examination related to the physical requirements of the position may be required. Immigration Reform & Control Act: All offers of employment are conditioned upon satisfactory proof of a person's identity and legal ability to work in the U.S. by the presentation of documents approved by the U.S. Attorney General. The University of California, Irvine will hire only individuals who are legally able to work in the U.S.

Privacy Notice
The State of California Information Practices Act of 1977, effective July 1, 1978, requires the University to provide the following information to individuals who are asked to supply information about themselves.

UCI Human Resources is requesting the information on this employment application form. The principal purposes for requesting this information are to select qualified applicants for employment, to notify applicants of the status of their applications, and to provide self-identification for affirmative action purposes.

Furnishing all information on this form is mandatory. Failure to provide any information requested may delay or prevent consideration of your application. Information furnished on this form may be used by various departments for establishing pools, arranging interviews, and contacting references.

Individuals have the right of access to this record as it pertains to themselves in accordance with applicable personnel policy or collective bargaining agreement.

The University official responsible for maintaining the information is the Human Resources Manager, 111 Theory, Suite 200, Irvine, California 92697-4600, (949) 824-5210.

Jeanne Clery Act
In accordance with 20 US code Section 1092(f) the "Jeanne Clery Disclosure of Campus Security policy and Campus Crime Statistics Act," and the Code of Federal Regulations (CFR), the University of California, Irvine publishes Campus Security Policies and 3 years of crime statistics. This information is available to students, employees, and applicants, and may be found at http://www.police.uci.edu. Paper copies of these reports will be made available upon request by contacting the UCI Campus Police at (949) 824-5223.

Mandatory Employment Notices
Including CAL/OSHA - Summary of Occupational Injuries and Illnesses - California, CAL/OSHA Notice of Access to Records - California, CAL/OSHA Notice of Safety and Health in the Workplace - California, Fair Employment & Housing Act - California, Emergency Phone Numbers List - California, Family and Medical Leave - California, Family and Medical Leave - Federal, Minimum Wage Notice - California, Minimum Wage Notice - Federal, Pay Day Notice - California, Polygraph Notice - Federal, Pregnancy Leave - California, Time Off to Vote - California, Nondiscrimination (Title 7), Age Discrimination in Employment Act, Americans with Disabilities Act, and Affirmative Action in Employment - Federal, Unemployment Insurance, Disability Insurance, and Paid Family Leave Notice - California, Uniformed Services Employment and Reemployment Rights Act (USERRA) Notice - Federal, Walsh-Healey Act (The Service Contract Act and Public Contracts Act) - Federal, Whistleblowing - California, Workers’ Compensation - California

http://atyourservice.ucop.edu/administrators/employment/mand_emp_note.html

Agency Fees
Effective January 1, 2000, a new State law requires that all employees who are in a bargaining unit represented by a labor union, must either join the union or pay a "fair share" fee to the union. The amount of the fair share fee is established by each union and varies by bargaining unit. Additional information is available on the Human Resources website at http://www.hr.uci.edu.

Applicants with Disabilities
Individuals with disabilities will be given reasonable accommodation in the application, interview and employment process upon request. For more information, contact an Employment Representative at Campus Human Resources (949) 824-5210.

Proof of Employment Eligibility
Under Federal Law, the University of California may employ only individuals who are legally able to work in the United States as established by providing documents specified in the Immigration and Control Act of 1986. Upon employment, applicants will be required to provide documentation to verify their identity and eligibility to work in the U.S. If you need information about acceptable documents, please call the Human Resources office (949) 824-5210.

Nondiscrimination and Affirmative Action Policy Statement
The University of California prohibits discrimination against or harassment of any person employed by or seeking employment with the University on the basis of race, color, national origin, religion, sex, gender identity, pregnancy (pregnancy, childbirth, and medical conditions related to pregnancy or childbirth), physical or mental disability, medical condition (cancer-related or genetic characteristics), ancestry, marital status, age, sexual orientation, citizenship, or status as a covered veteran (special disabled veteran, recently separated veteran, Vietnam era veteran, or any other veteran who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized). The University of California is an affirmative action/equal opportunity employer. The University undertakes affirmative action to assure equal employment opportunity for minorities and women, for persons with disabilities, and for covered veterans. University policy is intended to be consistent with the provisions of applicable State and Federal laws. Inquiries regarding the University's equal employment opportunity policy may be directed to: Equal Opportunity and Diversity, 103 Multipurpose Science and Technology Building, Irvine, CA 92697-1130, telephone (949) 824-5594.

I authorize the University to make inquiries about, and verify all statements on this application, and, AS APPROPRIATE, CONDUCT EMPLOYMENT-RELATED BACKGROUND CHECKS. I understand any misstatement, falsification or omission of material facts on this application or any supplement thereto, may constitute rejection for the position and if employed, grounds for dismissal.

* I have read and understand the Conditions of Employment as outlined above.	Yes No h●Yes ○No


IMPORTANT NOTE REGARDING E-SIGNATURE: By typing your full name below and submitting this application, you acknowledge and agree that your typed name represents your signed name (signature) and that you intend for this electronic signature to have the same force and effect as a manual (handwritten) signature.

* FULL NAME - ELECTRONIC AUTHORIZATION	1/10/2014

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