ROP APPLICATION

Directions: Please Print Legibly

Manzo
Julian
J
Name: __________________________________________

(Last)

(First)

April 29th, 2015

____________________

(Middle)

Date

625 East North Bear Creek

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
Merced
95340
_______________________________________________________________________________

(City)

(209 ) 753-9035
(Telephone Number)

(State)

(Zip Code)

manzojulian97@yahoo.com
743-8620
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

Position applied for:_______________________________________________________________

Raleys Courtesy Clerk
Skills and/or competencies which qualify you for this position:
I am a very hardworking, goal-oriented, and friendly person which is why I strongly believe I am the best
candidate for this position.

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:________________________________

Do you possess a valid California Drivers License?

No

Yes

_______________________
(Number)

RECORD OF EDUCATION

Name of School
High School

City/State

Merced High School

Course of
study or
major

Last year
completed

Did you
graduate?

GED

1 2 3 4

Graduating
this June

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:
I played soccer all four years while I attended Merced High School as well as played on competitive traveling
team. I am also currently the President of the Merced High Soccer club at Merced High.
FULL TIME

AVAILABILITY

PART TIME

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

All Day

4-Closing

4-Closing

4-Closing

4-Closing

4-Closing

All Day

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

N/A
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

To:

______

______

Mo / Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________
Hours Per Week:_________
Reason For Leaving:

From:

_________________________________________________
Supervisors Name:
_____________________________________________________

_________________________________________________

Title__________________________Last
Salary: _____________
N/A

_________________________________________________

Duties:

_________________________________________________

To:

______

______

Mo/ Yr

Mo/Yr

Total ____Yrs. ________Mo.

_________________________________________________

Hours Per Week:_________

Reason For Leaving:

_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________

From:

To:

______

______

Mo /Yr

Mo/Yr

N/A
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.

Ernie Cervantes

Complete Address (Include City, State, Zip)

2952 Tahoe Dr. Merced, CA 95340

Phone

Occupation_______

(209)201-7796
Truck Driver

________________________________________________________________________________________________________________________________
2. Tino

Jimenez

3450 Joerg Ave. Merced, CA 95340

(864)313-6531
Chemical Engineer

________________________________________________________________________________________________________________________________
3. Vanessa

Diaz

3555 San Vincent Ave. Merced, CA 95348

(209)631-9655
4th Grade Teacher

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________