Department of Civil Service

Program Resources

Applying for the 55-b/c Program

To apply for the 55-b/c Programs you must submit an application and supporting documentation. The application packet is available in PDF PDF Document Icon or Microsoft Word Microsoft Word Document Icon format. Select the format of your choice, print the packet, then mail it in to the address shown. If you select the Microsoft Word format, you can complete the packet on-line, before you print and mail it in.
A packet includes
  • Application (4 pages)
  • Physician's Questionnaire