Microsoft Word - Rop Job Application With Availablity Front-For Fillable

ROP APPLICATION
Directions: Please Print Legibly
Name: __________________________________________
Carreon Mariel Alyssa ____________________
April 25, 2017
(Last) (First) (Middle) Date
Present mailing address:___________________________________________________________

1210 Esplanade Dr.
(P.O. Box or Street Number)
Merced CA 95348
_______________________________________________________________________________
(City) (State) (Zip Code)
(209 ) 658-0345 ( )____________________ ____________________________

[email protected]
(Telephone Number) (Alternative Telephone Number) (Email Address)
Position applied for:_______________________________________________________________

Em-Tea Barista
Skills and/or competencies which qualify you for this position:

good social/communication skills, open and enthusiastic, fast learner, advanced math skills, experience
with cas register, detail-oriented, patient
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 High School Merced, CA 1 2 3 4 Not yet
College/ 1 2 3 4
University
Other
1 2 3 4
(Specify)
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Leadership
FULL TIME
AVAILABILITY PART TIME
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
3-6 3-6 4-8 3-6 3-6 10-1

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:
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. _________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
REFERENCES: Give the names of three persons not related to you.

Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.
Haydee Arreola
Teacher
________________________________________________________________________________________________________________________________
2. Thida Chang
Dentist
________________________________________________________________________________________________________________________________
3. James Rabago
OBGYN
________________________________________________________________________________________________________________________________
I authorize investigation of all statements contained in this application.

I understand that misrepresentation or omission of facts is cause for dismissal.
Date:_________________________Signature:_________________________________________________________________
N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf Revised 7/10

Microsoft Word - Rop Job Application With Availablity Front-For Fillable

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ROP APPLICATION

Directions: Please Print Legibly

Present mailing address:___________________________________________________________

(209 ) 658-0345 ( ) ________

Position applied for:_______________________________________________________________

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

Languages spoken and/or written (other than English):___________________________________

Do you possess a valid California Drivers License?

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

3-6 3-6 4-8 3-6 3-6 10-1

Supervisors Name: _________________________________________________

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

I authorize investigation of all statements contained in this application.

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