ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Mejia David ____________________
4-7-17
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

5306 White Rock rd
(P.O. Box or Street Number)

Le Grand California 95333

_______________________________________________________________________________
(City) (State) (Zip Code)

( 209 ) 761_5695 ( )____________________ ____________________________

dmejia209@hotmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Skills and/or competencies which qualify you for this position:
I know I am qualified for this position because I am a motivated and diligent worker. And I am eager to learn
in order to become a successful individual. I know I would be a great fit for your organization because I
work well with others, i'm bilingual (Spanish and English), I have had sales experience in the past, and
communicate well with others.
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 _______________________
(Number)

RECORD OF EDUCATION
Course of
study or Last year Did you Diploma
Name of School City/State major completed graduate? or degree
High School 1 2 3 4 diploma
Merced high school Merced pending

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

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

Merced High School Freshman Football, 2014

Merced High School Sophomore JV Football, 2015
Merced High School Junior Varsity Football, 2016
FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

no 3:30pm - 9:30pm 3:30pm - 9:30pm 3:30pm - 9:30pm

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

Period of Employment Job Title and Duties Performed Company Name, Address, and Phone Number
From: To:

06/01 Title__________________________Last Salary: _____________ _________________________________________________

______ ______
Mo / Yr Mo/Yr
Duties _________________________________________________
Total ____Yrs. ________Mo.
_________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

Supervisors Name: _________________________________________________

_____________________________________________________

From: To:
Title__________________________Last Salary: _____________ _________________________________________________
______ ______
Mo/ Yr Mo/Yr Duties: _________________________________________________
Total ____Yrs. ________Mo. _________________________________________________
Hours Per Week:_________
Reason For Leaving: _________________________________________________

_________________________________________________
Supervisors Name:
________________________________________________

From: To:
Title___________________________Last Salary: ____________ _________________________________________________
______ ______
Mo /Yr Mo/Yr 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:_________________________________________________________________

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