ROP APPLICATION

Directions: Please Print Legibly

Name: __________________________________________
Grace Samantha Marie ____________________
04 / 10 / 18
(Last) (First) (Middle) Date

Present mailing address:___________________________________________________________

3569 Santa Maria Ave
(P.O. Box or Street Number)

Merced California 95348

_______________________________________________________________________________
(City) (State) (Zip Code)

(209 ) 658 - 3722 ( 209 )____________________

761 - 4944 ____________________________
samanthaparis1000@gmail.com
(Telephone Number) (Alternative Telephone Number) (Email Address)

Position applied for:_______________________________________________________________

Receptionist

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

Time Management , Organization , Planning , Communication , Technicial Skills

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

None

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 Driver’s License?

‰ No ‰ Yes _______________________
Y2895205
(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 General 1 2 3 4 Pending
Education in June

College/ 1 2 3 4
University

Other
1 2 3 4
(Specify)

List appropriate extracurricular activities, clubs, organizations and courses for this position:
Water polo and Swimming helped me learn how to be adaptable and organizaed and to keep things in order to
help the other players. P.A.C.I.F.I.C Club taught me to be understanding and how to communicate appropriately.

FULL TIME
AVAILABILITY PART TIME

SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

Anytime 12pm - 7pm 8am - 12pm 12pm - 7pm 8am - 12pm 12pm - 7pm Anytime
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:
Housekeeper
Title__________________________Last $10 an Hour
Salary: _____________
672 Junipero court
_________________________________________________
Jan/17
______ April/18
______
Mo / Yr Mo/Yr
Duties
(209) 233 - 7247
_________________________________________________
1
Total ____Yrs. 3
________Mo.
Sanitized, mopped, vacumm, all areas of the house. _________________________________________________
1.5
Hours Per Week:_________
Reason For Leaving: _________________________________________________
Need more hours.
Supervisor’s Name: _________________________________________________
Julie Tripp
_____________________________________________________

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

_________________________________________________
Supervisor’s Name:
________________________________________________

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

_________________________________________________
Supervisor’s Name:
________________________________________________

REFERENCES: Give the names of three persons not related to you.

Name Complete Address (Include City, State, Zip) Phone Occupation_______
1.
Kit Grattan 205 West Olive Avenue, Merced CA 95344 (209) 617 - 3157
Teacher
________________________________________________________________________________________________________________________________

2. Stephen A. Jones 205 West Olive Avenue, Merced CA 95344 (209) 631 - 6832
Teacher
________________________________________________________________________________________________________________________________

3. Julie Tripp 1020 E Bellevue Rd, Atwater CA 95301 (209) 233 - 7247
Teacher
________________________________________________________________________________________________________________________________

I authorize investigation of all statements contained in this application.

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

Date:_________________________Signature:_________________________________________________________________