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ROP APPLICATION
Directions: Please Print Legibly
Saechao
Lydia
Ann
Name: __________________________________________

(Last)

(First)

April 22, 2015

____________________

(Middle)

Date

1329 Derby Dr.

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95348
_______________________________________________________________________________

(City)

(State)

( 209 ) 631-0838

(Telephone Number)

(Zip Code)

LydiaSaechao2@gmail.com
)____________________ ____________________________

(Alternative Telephone Number)

(Email Address)

Internship
Position applied for:_______________________________________________________________

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

Works well with others;Good listening skills;Responsible;Time management and organizational skills

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

N/A
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

City/State

Merced High School

College/
University

N/A

Other
(Specify)

N/A

Course of
study or
major

Merced,CA

G.E.

Last year
completed
1 2 3 4

Did you
graduate?

Diploma
or degree

Yes

Diploma

1 2 3 4

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
ROP Marketing, Kiwins Club

FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

2pm-8pm

4pm-10pm

4pm-10pm

4pm-10pm

4pm-10pm

4pm-Close

Open-Close

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

ROP
Foot Locker
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Sort clothes, Tidy clothes, Check display

merchandise, Organize packages and new
merchandise.

_________________________________________________

Supervisors Name:
Josiah Gurrola
_____________________________________________________

_________________________________________________

Title__________________________Last Salary: _____________

_________________________________________________

Duties:

_________________________________________________

To:

01/15
______

Present
______

Mo / Yr

Mo/Yr

3
Total ____Yrs. ________Mo.

7
Hours Per Week:_________
Reason For Leaving:

Still There

From:

Foot Locker

780 Merced Mall

Merced,CA 95348
(209) 384-1589

_________________________________________________

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.

Lisa Escobedo

Complete Address (Include City, State, Zip)

205 Olive Ave. Merced,CA 95341

Phone

(209)617-4628

Occupation_______

Marketing Teacher

________________________________________________________________________________________________________________________________
2. Florentino

Garcia

1700 Fulton Rd. Santa Rosa,CA 95403

528-5260 ext. 6634

History Teacher

________________________________________________________________________________________________________________________________
3.

Josiah Gurrola

780 Merced Mall Merced,CA 95348

(209)384-1589
Manager/Supervisor

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

4/22/2015
Date:_________________________Signature:_________________________________________________________________

N:\ROP\Charlotte Klock\ROP Forms\Forms\ROP Job Application with availbility back-for fillable.rtf

Revised 7/10