ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Foster Frances Marion ____________________
April 7, 2017
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

3576 San Jose Ave.
(P.O. Box or Street Number)

Merced CA 95348
_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 777-5672 ( )____________________ ____________________________

frannifoster114@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Home-helper

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

I am skilled in maintaining a cleaning home enviroment. This includes dusting, mopping, vacuuming,
dishes, laundry and other means of house cleaning. I have some knowlege of first aid and meal prepare.

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

some 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 Merced High school Merced, CA 1 2 3 4

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

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

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

7am- 11pm 3:30pm - 11pm 3:30pm - 11pm 3:30pm - 11pm 3:30pm - 11pm 3:30pm - 11pm 7am - 11pm
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:
House keeping
Title__________________________Last $25/ wk
Salary: _____________
Robert Calhoun
_________________________________________________
jan/ 2013
______ Apr/ 2017
______
Mo / Yr Mo/Yr
Duties _________________________________________________
4
Total ____Yrs. 4
________Mo.
Scrubbing toliets and showers in both bathrooms (209) 658-4656
_________________________________________________
12.5 hrs
Hours Per Week:_________ mopping, dusting, vacuuming, laudry, emptying
Reason For Leaving: _________________________________________________
trash
Supervisors Name: _________________________________________________
Robert Calhoun
_____________________________________________________

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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