Rop Application: Directions: Please Print Legibly

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ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Shelton Whitney N ____________________
may 1st, 2017
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________


1177 Bel Air Drive
(P.O. Box or Street Number)

Merced CA 95340
_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 6176884 ( )____________________ ____________________________


[email protected]
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________


Walgreens - customer service associate

Skills and/or competencies which qualify you for this position:


Diligent, Ability to use "positive language",

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:________________________________

Do you possess a valid California Drivers License?


No Yes _______________________
(Number)

RECORD OF EDUCATION
Course of
study or Last year Did you Diploma
Name of School City/State major completed graduate? or degree
High School Merced Merced,CA 1 2 3 4 Yes Diploma

College/ 1 2 3 4
Merced Community College Merced, CA undecided
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Link Crew , Key club , Zoo Volunteer

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

/ 12-4 12-4 12-4 12-4 12-4 12-6


RECORD OF EMPLOYMENT: (Begin with your most recent job)

Period of Employment Job Title and Duties Performed Company Name, Address, and Phone Number
From: To:
Babysitter
Title__________________________Last $15/day
Salary: _____________
N/A
_________________________________________________
4/16
______ ---
______
Mo / Yr Mo/Yr
Duties _________________________________________________
1
Total ____Yrs. 1
________Mo.
Provide entertainment and nutritious snacks/meals _________________________________________________
varies
Hours Per Week:_________ for child while parents were unavailable.
Reason For Leaving: _________________________________________________

Supervisors Name: _________________________________________________


/
_____________________________________________________

From: To:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo/ Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

REFERENCES: Give the names of three persons not related to you.


Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.
Mary Martinez 22196 center street 2096174021
N/A
Castro valley, CA 94546
________________________________________________________________________________________________________________________________

2. John Whatley 3056 coppertree ct 2093841501


cook
Merced, CA 95340
________________________________________________________________________________________________________________________________

3.

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.


I understand that misrepresentation or omission of facts is cause for dismissal.

Date:_________________________Signature:_________________________________________________________________

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