ROP APPLICATION
Directions: Please Print Legibly
Garcia Luis Angel
Name: __________________________________________
(Last)
(First)
5-1-2015
____________________
(Middle)
Date
1234 W. East Street
Present mailing address:___________________________________________________________
(P.O. Box or Street Number)
CA
Merced
95340
_______________________________________________________________________________
(City)
(209 ) 123-4567
(Telephone Number)
(State)
(Zip Code)
applicationemail@[Link]
123-4567
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)
Position applied for:_______________________________________________________________
Cashier
Skills and/or competencies which qualify you for this position:
Very comprehensive with numbers and arithmetic, Responsible, Accurate, Friendly, Familiar with
Technology.
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
Merced, CA
College/
University
General
Education
Last year
completed
Did you
graduate?
Diploma
or degree
1 2 3 4
Not yet
Not Yet
1 2 3 4
Other
(Specify)
1 2 3 4
List appropriate extracurricular activities, clubs, organizations and courses for this position:
FULL TIME
AVAILABILITY
PART TIME
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
7A.M.-10P.M.
4P.M.-9P.M.
4P.M.-9P.M.
4P.M.-9P.M.
4P.M.-9P.M.
4P.M.-9P.M.
7A.M.-10P.M.
RECORD OF EMPLOYMENT: (Begin with your most recent job)
Period of Employment
From:
Job Title and Duties Performed
Company Name, Address, and Phone Number
Title__________________________Last Salary: _____________
_________________________________________________
Duties
_________________________________________________
To:
______
______
Mo / Yr
Mo/Yr
Total ____Yrs. ________Mo.
_________________________________________________
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.
Jim Holland
Complete Address (Include City, State, Zip)
1243 E. West Ave., Merced, CA, 95348
Phone
Occupation_______
(209) 342-3289
High School Teacher
________________________________________________________________________________________________________________________________
2. Keith
Petiti
1432 N. South Dr., Merced, CA, 95342
(209) 423-8239
High School Teacher
________________________________________________________________________________________________________________________________
3. Dawn
Garrett
1342 S. North Blvd., Merced, CA, 95344
(209) 243-2893
High School 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:_________________________________________________________________
