Job Application
Job Application
(Last)
(First)
May 7, 2014
____________________
(Middle)
Date
1120 Thornton Rd
Present mailing address:___________________________________________________________
(City)
(State)
(209 ) 7619934
(Zip Code)
[email protected]
7618289
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
(Telephone Number)
Spanish
Languages spoken and/or written (other than English):___________________________________
Have you ever been convicted, pleaded guilty or no contest to a misdemeanor or felony?
No
Yes
If yes, explain:________________________________
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Course of
study or
major
Last year
completed
Did you
graduate?
Diploma
or degree
Merced, CA
General
Education
1 2 3 4
Expected
Expected
College/
University
N/A
N/A
N/A
1 2 3 4
N/A
N/A
Other
(Specify)
N/A
N/A
N/A
1 2 3 4
N/A
N/A
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Volunteer at Merced Animal Rescue
FULL TIME
AVAILABILITY
SUNDAY
N/A
MONDAY
TUESDAY
WEDNESDAY
Closing Shift
PART TIME
THURSDAY
FRIDAY
SATURDAY
Closing Shift
_________________________________________________
Duties
_________________________________________________
To:
______
______
Mo / Yr
Mo/Yr
_________________________________________________
Hours Per Week:_________
Reason For Leaving:
From:
_________________________________________________
Supervisors Name:
_____________________________________________________
_________________________________________________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Cathy White
Phone
Occupation_______
209-385-6465
Computer Teacher
Merced, CA 95341
________________________________________________________________________________________________________________________________
2. Tammie
Meyer
209-385-6465
Health Teacher
Merced, CA 95341
________________________________________________________________________________________________________________________________
3. Leticia
Villa
209-725-7170
Merced, CA 95341
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________