Job App
Job App
(Last)
(First)
05/3/14
____________________
(Middle)
Date
(City)
( 209 ) 724-0804
(State)
(Zip Code)
[email protected]
201-8577
( 209 )____________________
____________________________
(Telephone Number)
(Email Address)
Yes
If yes, explain:________________________________
Yes
_______________________
F3130773
(Number)
RECORD OF EDUCATION
Name of School
High School
College/
University
Course of
study or
major
City/State
Last year
completed
Did you
graduate?
Merced, CA
1 2 3 4
No
Merced College
Merced, CA
1 2 3 4
No
Other
(Specify)
Diploma
or degree
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Future Farmers of America (FFA)
California Scholarship Foundation (CSF)
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
2-10
2-10
2-10
2-10
2-10
Floor associate
Title__________________________Last
Salary: _____________
_________________________________________________
Duties
_________________________________________________
To:
04/13
______
05/14
______
Mo / Yr
Mo/Yr
1
1
Total ____Yrs. ________Mo.
12
Hours Per Week:_________
Reason For Leaving:
From:
Abercrombie
(209) 549-2938
_________________________________________________
_________________________________________________
Supervisors Name:
Jeremy Little
_____________________________________________________
_________________________________________________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Diana Butts
Phone
Occupation_______
(209) 384-6036
Program Assistant
________________________________________________________________________________________________________________________________
2. Debi
Swartz
(209) 384-6016
Counselor
________________________________________________________________________________________________________________________________
3.
Victor Jimenez
Unknown
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________
Revised 7/10