Professional Documents
Culture Documents
(Last)
(First)
05/05/14
____________________
(Middle)
Date
140 T St
Present mailing address:___________________________________________________________
(City)
(State)
(209 ) 626-7130
(Telephone Number)
(Zip Code)
)____________________ ____________________________
(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
City/State
Merced High
Course of
study or
major
Last year
completed
Did you
graduate?
Basic
1 2 3 4
pending
june 4
Merced CA
College/
University
Diploma
or degree
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
M.E.CH.A
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
no
yes
yes
yes
yes
yes
no
_________________________________________________
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:
________________________________________________
_________________________________________________
Jocelyn
323 Gst
Phone
Occupation_______
(209)819-1630
________________________________________________________________________________________________________________________________
2. Ana
144 Tst
(209)947-2316
________________________________________________________________________________________________________________________________
3.
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________