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ROP APPLICATION
Directions: Please Print Legibly
Guerrero
Johnathan
Humberto
Name: __________________________________________

(Last)

(First)

April 11, 2016

____________________

(Middle)

Date

878 Sonora Ave

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

California
95340
Merced
_______________________________________________________________________________

(City)

(State)

( 209 ) 756-2515

(Zip Code)

King15John@outlook.com
631-5051
( 209 )____________________
____________________________
(Alternative Telephone Number)
(Email Address)

(Telephone Number)

Assets teacher
Position applied for:_______________________________________________________________

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

Critical Thinking, Multitasker, Listening skills, Social and Communication Skills, Empathy,

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

High School

Name of School

City/State

Course of
study or
major

Merced High School

Merced/CA

College/
University

Last year
completed
1 2 3 4

Did you
graduate?

Diploma
or degree

Pending
June 2016

Diploma

1 2 3 4

Other
(Specify)

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:
MECHA, Key Club, Merced court house clean up, Kiddieland, Ocean clean up, Farmers market, ASSETS
volunteer.
FULL TIME

AVAILABILITY
SUNDAY

N/A

MONDAY

3:30-6:30pm

TUESDAY

3:30-6:30pm

WEDNESDAY

3:30-6:30pm

THURSDAY

3:30-6:30pm

FRIDAY

3:30-6:30pm

PART TIME

SATURDAY

N/A

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

Period of Employment
From:

Job Title and Duties Performed

Company Name, Address, and Phone Number

$215
ASSETS assistent
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Help students with homework, paper work, storage,

teacher assistant, communicate, yard dutie.

_________________________________________________

To:

8/2015
______

4/2016
______

Mo / Yr

Mo/Yr

9
Total ____Yrs. ________Mo.
Hours Per Week:_________
Reason For Leaving:

From:

ASSETS, 945 Buena Vista Dr, (209)658-0370

_________________________________________________
Supervisors Name:
Ms. Maggie
_____________________________________________________

_________________________________________________

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.

Ms. Delon

Complete Address (Include City, State, Zip)

Phone

Occupation_______

205 W Olive Ave, Merced CA 95348

Eng/Drama teacher

________________________________________________________________________________________________________________________________
2. Mr.

Aguayo

205 W Olive Ave, Merced CA 95348

Math teacher

________________________________________________________________________________________________________________________________
3.

Mr. Villa

205 W Olive Ave, Merced CA 95348

Special Ed-Rsp/Sdc

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

4/18/2016
Date:_________________________Signature:_________________________________________________________________

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

Revised 7/10