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ROP APPLICATION
Directions: Please Print Legibly
Llamas
Adrian
Jesus
Name: __________________________________________

(Last)

(First)

04/19/16
____________________

(Middle)

Date

651 west 11th street

Present mailing address:___________________________________________________________

(P.O. Box or Street Number)

Ca
95341
Merced
_______________________________________________________________________________

(City)

(State)

( 209 ) 3548601

(Telephone Number)

(Zip Code)

allamas103148@muhsdstudents.org
)____________________ ____________________________

(Alternative Telephone Number)

(Email Address)

sales associate
Position applied for:_______________________________________________________________

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

Bilingual
very cooperative
teamworker

Languages spoken and/or written (other than English):___________________________________

spanish
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

_______________________
f7672695

(Number)

RECORD OF EDUCATION

Name of School
High School

College/
University

City/State

Merced High School

Merced/CA

na

na

Course of
study or
major

Other
(Specify)

Last year
completed
1 2 3 4

na

1 2 3 4

Did you
graduate?

Diploma
or degree

yes

diploma

na

na

1 2 3 4

List appropriate extracurricular activities, clubs, organizations and courses for this position:

AVAILABILITY
SUNDAY

MONDAY

TUESDAY

WEDNESDAY

FULL TIME
PART TIME

THURSDAY

FRIDAY

SATURDAY

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

Period of Employment
From:

Company Name, Address, and Phone Number

11/hour
orchard worker
Title__________________________Last
Salary: _____________

_________________________________________________

Duties

_________________________________________________

Thinning
Prunning

_________________________________________________

To:

6/15
______

8/15
______

Mo / Yr

Mo/Yr

2
Total ____Yrs. ________Mo.

60
Hours Per Week:_________
Reason For Leaving:

From:

Job Title and Duties Performed

Remley Orchards

Dryden,Washington 98821
(509)782 3981

_________________________________________________
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

Complete Address (Include City, State, Zip)

Phone

Occupation_______

1.

________________________________________________________________________________________________________________________________
2.

________________________________________________________________________________________________________________________________
3.

________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________

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

Revised 7/10