Jobapplication
Jobapplication
(Last)
(First)
5/12/14
____________________
(Middle)
Date
(City)
(209 ) 2610331
(Telephone Number)
(State)
(Zip Code)
[email protected]
2614373
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
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
Course of
study or
major
City/State
Merced, CA
General
Education
College/
University
Last year
completed
Did you
graduate?
Diploma
or degree
1 2 3 4
Yes
General
Education
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Key Club, M.e.ch.a, Varsity softball team
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
yes
yes
yes
yes
yes
yes
yes
$60.00
Child Care Provider
Title__________________________Last
Salary: _____________
_________________________________________________
Duties
_________________________________________________
_________________________________________________
To:
8/12
______
5/14
______
Mo / Yr
Mo/Yr
24
2
Total ____Yrs.
________Mo.
8
Hours Per Week:_________
Reason For Leaving:
From:
75 Westmount Ct.
(209)761-1082
_________________________________________________
Supervisors Name:
Shane Friesen
_____________________________________________________
_________________________________________________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Christy Resendez
Phone
Occupation_______
(209)947-4949
Teacher
________________________________________________________________________________________________________________________________
2. Bart
McAffe
(209)777-1682
Coach
________________________________________________________________________________________________________________________________
3. Tammie
Meyer
(209)756-8901
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________