Professional Documents
Culture Documents
(Last)
(First)
05/07/2014
____________________
(Middle)
Date
(City)
(209 ) 988-0295
(State)
(Telephone Number)
(Zip Code)
jmscott209@gmail.com
)____________________ ____________________________
(Email Address)
Yes
If yes, explain:________________________________
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
High School
City/State
Course of
study or
major
Merced, CA
College/
University
Last year
completed
Did you
graduate?
Diploma
or degree
1 2 3 4
Yes
Diploma
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
Secretary work at Mercy Medical Center
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
8am-2pm
4pm-8pm
4pm-8pm
4pm-8pm
4pm-8pm
4pm-8pm
SATURDAY
_________________________________________________
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:
________________________________________________
_________________________________________________
Phone
Occupation_______
Bill Freitas
________________________________________________________________________________________________________________________________
2. Sarah
Morgan
________________________________________________________________________________________________________________________________
3. Keith
Petiti
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________