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ROP APPLICATION
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Vega
Joel
Name: __________________________________________
(Last)
(First)
04/30/2015
____________________
(Middle)
Date
(City)
( 209 ) 617-3598
(Telephone Number)
(State)
(Zip Code)
Jvega102615@muhsdstudents.org
726-1714
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Abercrombie Model
Position applied for:_______________________________________________________________
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
General
Last year
completed
1 2 3 4
Did you
graduate?
Diploma
or degree
No
NA
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
FULL TIME
AVAILABILITY
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
PART TIME
THURSDAY
FRIDAY
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:
________________________________________________
_________________________________________________
Donna Acheson
205 WEST
Phone
Occupation_______
Teacher
Merced, CA 95348
________________________________________________________________________________________________________________________________
2.
Mayra Flores
(209) 265-3542
Teacher
Merced, CA 95348
________________________________________________________________________________________________________________________________
3.
Andrea DeLeon
Merced, CA 95348
(209)769-6610
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________
Revised 7/10