Application Form - SAMPLE ONLY - 2025-2027 Staff Advisor to the UC Board of Regents

Sep 19, 2026

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Sample-only application form for the 2025-2027 UC Staff Advisor position to the Board of Regents. The form guides applicants through personal information, employment history, educational background, UC committee and community service within the last 10 years, and professional references. It also requires perspective-based essay responses on contributions to UC and staff engagement, plus a signature and attestation confirming eligibility and readiness for a two-year appointment starting July 1, 2025.

LanguageEnglish

CategoryForms

FormatPDF

Pages6

Reading Time2 min

AccessFree to download

Personal Information

Employment History

Educational Background

UC, Committee, and Community Service

Professional References

Essay Responses - From Your Perspective

Signature Page - Sample Only

Application Form – SAMPLE ONLY 2025-2027 Staff Advisor to the UC Board of Regents 􀃖 NOTE: This sample is provided solely for purpose of allowing you to preview questions and prepare response. It should not be used to submit applications. 􀃖 Apply through the UC Staff Advisor Designate Application Smartsheet form. 􀃖 If you have any questions or experience any barriers with completing the Smarthsheet form, please [contact](contact StaffAdvisorRecruitment@ucop.edu)[ ](contact StaffAdvisorRecruitment@ucop.edu)[StaffAdvisorRecruitment@ucop.edu](contact StaffAdvisorRecruitment@ucop.edu). Questions indicated with an * are required within the application. Personal Information 1. First & Last Name* 2. Pronouns 3. UC location (campus/medical center/administrative office)* 4. Department* 5. Position/Title* 6. Employee Identification Number 7. Campus/Lab/Office Mailing Address* 8. Campus/Lab/Office Telephone Number* 9. Campus/Lab/Office Email Address* Employment History Starting with your most current position, include your employment history. 10. Length of Career Service at the University of California* Include years and months. (The MINIMUM collective UC service required to serve as a Staff Advisor is 5 years.) 11. Date of Initial Hire at the University of California* 12. Current Role/Title* 13. Date Started* 14. Previous Roles/Titles a. b. c. d. Educational Background Include all business, technical, military, professional, college and university institutions attended. (List name of institution, years attended and degrees/certificates attained. ) 15. Institution 1* Name of Institution 1* : Degree or Certificate Attained 1* : Start Date 1* : End Date 1* : 16. Institution 2 Name of Institution 2: Degree or Certificate Attained 2: Start Date 2: End Date 2: 17. Institution 3 Name of Institution 3: Degree or Certificate Attained 3: Start Date 3: End Date 3: UC, Committee, and Community Service It is important in this role to have an understanding and experience in working through issues facing UC, especially as they relate to staff. List UC, committee, community service, or other major volunteer commitments within the past 10 years. (You may, at your discretion, exclude the names of organizations that reveal your race, color, religion, national origin, ancestry, disability, or characteristics of any other protected category.) 18. Organization 1* Name of Organization 1* : Your Role 1* : Start Date 1* : End Date 1: 19. Organization 2 Name of Organization 2: Your Role 2: Start Date 2: End Date 2: 20. Organization 3 Name of Organization 3: Your Role 3: Start Date 3: End Date 3: 21. Organization 4 Name of Organization 4: Your Role 4: Start Date 4: End Date 4: 22. Organization 5 Name of Organization 5: Your Role 5: Start Date 5: End Date 5: Professional References Provide three University of California references. Please notify your references at the time you submit this application, that they will be asked to respond to specific questions concerning your qualifications for this role. These questions will be made available to your references should you become a semi-finalist. 23. Person 1* Name 1* : Title 1* : Email Address 1* : Contact Number 1* : Relationship to Candidate 1* : 24. Person 2* Name 2* : Title 2* : Email Address 2* : Contact Number 2* : Relationship to Candidate 2* : 25. Person 3* Name 3* : Title 3* : Email Address 3* : Contact Number 3* : Relationship to Candidate 3* : Essay Responses-From Your Perspective Please answer the following questions. Note: Answers to each question should be thorough, but NOT exceed 500 words. (You may upload your essay responses as a separate attachment. ) 26. Essay One: Contribution to UC & Past Experience* If you are selected to fill this role, what do you feel would be your contribution to the University, the Board

FAQs

How should applicants submit this UC Staff Advisor application?

Submit the application through the UC Staff Advisor Designate Application Smartsheet form, as instructed in the sample.

What are the minimum service requirements referenced in the form?

The form states the minimum collective UC service required to serve as a Staff Advisor is 5 years, and eligibility is certified based on at least 5 years of career service.

What does the essay section require and what is the word limit?

Applicants must answer the provided essay prompts thoroughly without exceeding 500 words per question, with an option to upload essay responses as a separate attachment.

Sep 19, 2026

Upload by Terk