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ROP APPLICATION
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Daniel
Teng
Name: Wilson
__________________________________________
(Last)
(First)
5/7/15
____________________
(Middle)
Date
(City)
(209 ) 631-5123
(State)
(Telephone Number)
(Zip Code)
)____________________ ____________________________
(Email Address)
stock
Position applied for:_______________________________________________________________
none
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:________________________________
Yes
_______________________
(Number)
RECORD OF EDUCATION
Name of School
City/State
Course of
study or
major
High School
Last year
completed
Did you
graduate?
Diploma
or degree
yes
diploma
1 2 3 4
Merced, CA
general ED
College/
University
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
evening
evening
evening
evening
evening
evening
evening
Gamestop
_________________________________________________
Duties
1340
W Olive Ave
_________________________________________________
Merced,
CA
_________________________________________________
To:
10/13
______
2/14
______
Mo / Yr
Mo/Yr
4
Total ____Yrs. ________Mo.
30
Hours Per Week:_________
Reason For Leaving:
(209)723-3234
_________________________________________________
temporary
From:
Supervisors Name:
Paul
_____________________________________________________
_________________________________________________
_________________________________________________
Duties:
_________________________________________________
To:
______
______
Mo/ Yr
Mo/Yr
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
From:
To:
______
______
Mo /Yr
Mo/Yr
_________________________________________________
Duties:
_________________________________________________
_________________________________________________
_________________________________________________
Supervisors Name:
________________________________________________
_________________________________________________
Phone
Occupation_______
1.
Mr.Schneider
________________________________________________________________________________________________________________________________
2.
Mrs.Garrett
________________________________________________________________________________________________________________________________
3.
Mr.Gaestel
631-6477
Merced, CA
Teacher
________________________________________________________________________________________________________________________________
Date:_________________________Signature:_________________________________________________________________
Revised 7/10