ROP APPLICATION

Directions: Please Print Legibly

Richard
Travante
Name: __________________________________________

(Last)

(First)

May 7, 2014
____________________

(Middle)

Date

587 Collins Dr Apt. #11

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

Ca
Merced
95348
_______________________________________________________________________________

(City)

(209 ) 769-9590
(Telephone Number)

(State)

(Zip Code)

Trichard101213@muhsdstudents.org
777-7777
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

Coach
Skills and/or competencies which qualify you for this position:
Because i've also played sports
I've coached before while I was in high school

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

Name of School
High School

College/
University

City/State

Merced high school

Merced, Ca

Fresno City

Merced,Ca

Course of
study or
major

Other
(Specify)

Business

Last year
completed

Did you
graduate?

Diploma
or degree

1 2 3 4

pinding

Deploma

1 2 3 4

pinding

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:

FULL TIME

AVAILABILITY
SUNDAY

MONDAY

PART TIME

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

Availabe

Availabe

Availabe

Availabe

SATURDAY

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

200
CVS Pharmicy
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

To:

3/14
______

4/13
______

Mo / Yr

Mo/Yr

1
0
Total ____Yrs.
________Mo.
_________________________________________________

48
Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
Supervisors Name:
_____________________________________________________

_________________________________________________

Title__________________________Last Salary: _____________

_________________________________________________

Duties:

_________________________________________________

To:

______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________

From:

To:

______

______

Mo /Yr

Mo/Yr

Title___________________________Last Salary: ____________

_________________________________________________

Duties:

_________________________________________________

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________

Supervisors Name:
________________________________________________

_________________________________________________

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

Name
1.

Mr.Humprey

Complete Address (Include City, State, Zip)

Phone

Occupation_______

205 west olive Merced

________________________________________________________________________________________________________________________________
2. Mr.Nava

205 west olive Merced

________________________________________________________________________________________________________________________________
3. Mr.Smoot

205 west olive Merced

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________